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https://www.readbyqxmd.com/read/29781963/comorbidities-and-mobility-in-lower-limb-prosthesis-users
#1
Shane R Wurdeman, Phillip M Stevens, James H Campbell
OBJECTIVE: To determine the impact of comorbidities on mobility in patients with lower limb prostheses. DESIGN: Cohort database chart review examining mobility in lower limb prosthesis users grouped according to comorbidities. Regression models were used to determine significant predictor comorbidities for mobility. General linear univariate models were implemented to investigate differences in mobility among cohorts (n=596). RESULTS: Patient age and history of stroke, peripheral vascular disease, and anxiety/panic disorders were predictors of decreased mobility...
May 17, 2018: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/29770729/group-sequential-designs-for-negative-binomial-outcomes
#2
Tobias Mütze, Ekkehard Glimm, Heinz Schmidli, Tim Friede
Count data and recurrent events in clinical trials, such as the number of lesions in magnetic resonance imaging in multiple sclerosis, the number of relapses in multiple sclerosis, the number of hospitalizations in heart failure, and the number of exacerbations in asthma or in chronic obstructive pulmonary disease (COPD) are often modeled by negative binomial distributions. In this manuscript, we study planning and analyzing clinical trials with group sequential designs for negative binomial outcomes. We propose a group sequential testing procedure for negative binomial outcomes based on Wald statistics using maximum likelihood estimators...
January 1, 2018: Statistical Methods in Medical Research
https://www.readbyqxmd.com/read/29753629/impact-of-delayed-prescription-fill-on-readmission-rates-for-chronic-obstructive-pulmonary-disease-and-heart-failure
#3
Aaron Kovacik, Paula C Bell, Sean King, Amy Mallon, James Renfroe, Charles Dyer
OBJECTIVES: In an effort to reduce reimbursement penalty from the Centers for Medicare and Medicaid Services, hospitals have looked to evaluate the effectiveness of existing programs as well as adopt innovative practices to reduce 30-day readmission rates. The objective of this study was to evaluate the impact of delaying prescription fill on 30-day readmission rates for patients with heart failure (HF) and chronic obstructive pulmonary disease (COPD). Identifying an association between delaying prescription fill and readmission rate would validate programs that provide patients with their medications before discharge...
May 9, 2018: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/29749645/right-ventricular-dyssynchrony-and-its-improvements-after-pulmonary-rehabilitation-in-patients-with-chronic-obstructive-pulmonary-disease
#4
Batur Kanar, Beste Ozben, Elif Yıldırım, İpek Ozmen, Rüya Aydin
PURPOSE: Whether pathologic alterations of right ventricle (RV) in chronic obstructive pulmonary disease (COPD) affect intra- and interventricular dyssynchrony due to changes in mechanical activation of the septum and RV is unclear. The aim of this study was to determine mechanical activation and its changes after pulmonary rehabilitation program (PRP) with speckle tracking echocardiography (STE) in COPD patients. METHODS: After the exclusion of 15 patients due to poor echogenicity and 5 patients not tolerating PRP out of 69 consecutive COPD patients undergoing PRP, the remaining 49 patients and 41 healthy subjects were enrolled...
May 11, 2018: Echocardiography
https://www.readbyqxmd.com/read/29746142/pulmonary-vascular-involvement-in-copd-is-there-a-pulmonary-vascular-phenotype
#5
Gabor Kovacs, Alvar Agusti, Joan Albert Barberà, Bartolome Celli, Gerard Criner, Marc Humbert, Don D Sin, Norbert Voelkel, Horst Olschewski
Although often clinically unrecognized, the pulmonary circulation is frequently affected in patients with chronic obstructive pulmonary disease (COPD), and the presence of pulmonary vascular disease is associated with poor prognosis and frequent exacerbations. In most cases the presenting pulmonary hypertension (PH) is relatively mild, but in a subset of COPD patients, the presence of certain clinical features supports the existence of a "pulmonary vascular phenotype". Such a phenotype would be characterized by severe pre-capillary PH with strongly elevated pulmonary vascular resistance, moderate airflow limitation, severely decreased diffusion capacity for carbon monoxide, normo- or hypocapnia, circulatory exercise limitation and progressive right heart failure...
May 10, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29742472/impact-of-postherpetic-neuralgia-a-six-year-population-based-analysis-on-people-aged-50-years-or-older-%C3%A2-%C3%A2-%C3%A2
#6
Cintia Muñoz-Quiles, Mónica López-Lacort, Alejandro Orrico-Sánchez, Javier Díez-Domingo
OBJECTIVES: To estimate the incidence and burden of postherpetic neuralgia (PHN) and to investigate risk factors for PHN in the Valencia Region of Spain. METHODS: Data were extracted from population and healthcare databases from the Valencia Region (2009-2014). Herpes zoster (HZ) and PHN were defined using ICD-9 codes and drug prescriptions in people aged ≥ 50 years. The risk of HZ patients for developing PHN and potential risk factors (diabetes mellitus, COPD and heart failure) were investigated...
May 6, 2018: Journal of Infection
https://www.readbyqxmd.com/read/29720300/chronic-obstructive-pulmonary-disease-and-heart-failure-self-management-kits-for-outpatient-transitions-of-care
#7
Paul Boylan, Tina Joseph, Genevieve Hale, Cynthia Moreau, Matthew Seamon, Renee Jones
OBJECTIVE: To develop heart failure (HF) and chronic obstructive pulmonary disease (COPD) self-management kits in an accountable care organization (ACO) to facilitate patients' self-care and prevent hospital readmissions. SETTING: Pharmacists practice in an outpatient-based ACO. They participate in interprofessional office visits with providers and independently manage maintenance pharmacotherapies. PRACTICE DESCRIPTION: Pharmacists collaborate with an interprofessional team within the ACO including physicians, nurses, case managers, and paramedics...
March 1, 2018: Consultant Pharmacist: the Journal of the American Society of Consultant Pharmacists
https://www.readbyqxmd.com/read/29717676/lung-and-heart-sounds-analysis-state-of-the-art-and-future-trends
#8
Ana L Padilla-Ortiz, David Ibarra
Lung sounds, which include all sounds that are produced during the mechanism of respiration, may be classified into normal breath sounds and adventitious sounds. Normal breath sounds occur when no respiratory problems exist, whereas adventitious lung sounds (wheeze, rhonchi, crackle, etc.) are usually associated with certain pulmonary pathologies. Heart and lung sounds that are heard using a stethoscope are the result of mechanical interactions that indicate operation of cardiac and respiratory systems, respectively...
2018: Critical Reviews in Biomedical Engineering
https://www.readbyqxmd.com/read/29706089/mortality-in-advanced-chronic-obstructive-pulmonary-disease-and-heart-failure-following-cardiopulmonary-rehabilitation
#9
Youjeong Kang, Bonnie G Steele, Robert L Burr, Cynthia M Dougherty
Cardiopulmonary rehabilitation (CR) improves physical function and quality of life (QoL) in chronic obstructive pulmonary disease (COPD) and heart failure (HF), but it is unknown if CR improves outcomes in very severe disease. This study's purpose was to describe functional capacity (6-min walk distance [6MWD], steps/day), symptoms (dyspnea, depression), QoL (Short-Form Health Survey-Veterans [SF-36 V]) and cardiopulmonary function ( N-terminal pro-brain natriuretic peptide [NT-proBNP], forced expiratory volume in 1 s [FEV1 ]), and derive predictors of mortality among patients with severe COPD and HF who participated in CR...
January 1, 2018: Biological Research for Nursing
https://www.readbyqxmd.com/read/29705784/coexisting-heart-failure-and-chronic-obstructive-pulmonary-disease-report-of-two-cases-treated-with-indacaterol-glycopyrronium
#10
Eugenio Roberto Cosentino, Daniela Degli Esposti, Rinaldo Miceli, Crescenzio Bentivenga, Matteo Landolfo, Ilaria Ricci Iamino, Luca Spinardi, Gianluigi Magri, Claudio Borghi
Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality worldwide, and it is associated with a high economic burden. Heart failure shares some general symptoms with COPD; thus, diagnosing COPD is difficult in subjects with a history of heart failure, and spi-rometry is mandatory for confirmation. Moreover, COPD is a highly prevalent comorbidity negatively impacting the outcome of heart failure patients. We document here the treatment with indacaterol/glycopyrronium in 2 patients with concomitant COPD and heart failure...
2018: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/29678648/determinants-of-health-related-quality-of-life-1-year-after-pulmonary-thromboendarterectomy
#11
Oksana Kamenskaya, Asya Klinkova, Irina Loginova, Alexander Chernyavskiy, Alexander Edemskiy, Vladimir V Lomivorotov, Alexander Karaskov
AIM: Pulmonary thromboendarterectomy (PTE) is a recognized treatment for patients with chronic thromboembolic pulmonary hypertension (CTEPH), with good long-term haemodynamic results. The aim of this study was to test the hypothesis that the dynamics of health-related quality of life (QoL), 1 year after PTE, depends both on the clinical determinants associated with the underlying disease and the adverse events occurring in the early postoperative period. METHODS: This prospective cohort study included 136 patients with CTEPH...
April 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29672125/submassive-pulmonary-embolism
#12
Parth M Rali, Gerard J Criner
Pulmonary Embolism (PE) presents a spectrum of hemodynamic consequences ranging from being asymptomatic to a life-threatening medical emergency. Management of sub massive and massive PE often involves clinicians from multiple specialties that can potentially delay the development of a unified treatment plan. Additionally, patients with submassive PE can deteriorate after their presentation and require escalation of care. Underlying comorbidities like chronic obstructive pulmonary disease (COPD), cancer, congestive heart failure and interstitial lung disease can impact the patient's hemodynamic ability to tolerate submassive PE...
April 19, 2018: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29652593/vitamin-d-status-in-hospitalized-chronically-ill-patients
#13
Raef Malak Botros, Mona Mohamed AbdElsalam Besibes, Ahmed Mohamed Bahaaeldin, Sherihan Abo Elyazed
OBJECTIVES: Vitamin D deficiency is rarely considered or treated in critically ill patients. Deficiency of 25-hydroxy vitamin D [25(OH)D] prior to hospital admission might be a significant predictor of short- and long-term all cause patient mortality in a critically ill patient. The aim of this work is to investigate the prevalence of vitamin D deficiency in hospitalized patients and its relation to the length of stay and outcome of hospitalization. METHODS: Prospective cohort study performed on 80 patients admitted with acute deterioration of their chronic illness...
April 13, 2018: Journal of the American College of Nutrition
https://www.readbyqxmd.com/read/29649405/economic-impact-of-early-inpatient-palliative-care-intervention-in-a-community-hospital-setting
#14
James Fitzpatrick, Matthew Mavissakalian, Tisha Luciani, Yijing Xu, Amber Mazurek
BACKGROUND: Inpatient palliative care programs have demonstrated financial benefit for the hospital and improved quality of care for patients with advanced disease. Previous studies on this subject have focused on comparisons between palliative and traditional care. The financial and clinical effects of early versus late palliative care intervention are less well documented. OBJECTIVE: The aims of this study are to review the financial and quality outcomes that early palliative care intervention has on appropriate inpatients in the community hospital setting...
March 20, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29644927/disease-specific-clinical-pathways-are-they-feasible-in-primary-care-a-mixed-methods-study
#15
Anders Grimsmo, Audhild Løhre, Tove Røsstad, Ingunn Gjerde, Ina Heiberg, Aslak Steinsbekk
OBJECTIVE: To explore the feasibility of disease-specific clinical pathways when used in primary care. DESIGN: A mixed-method sequential exploratory design was used. First, merging and exploring quality interview data across two cases of collaboration between the specialist care and primary care on the introduction of clinical pathways for four selected chronic diseases. Secondly, using quantitative data covering a population of 214,700 to validate and test hypothesis derived from the qualitative findings...
June 2018: Scandinavian Journal of Primary Health Care
https://www.readbyqxmd.com/read/29615204/effect-of-air-quality-alerts-on-human-health-a-regression-discontinuity-analysis-in-toronto-canada
#16
Hong Chen, Qiongsi Li, Jay S Kaufman, Jun Wang, Ray Copes, Yushan Su, Tarik Benmarhnia
BACKGROUND: Ambient air pollution is a major health risk globally. To reduce adverse health effects on days when air pollution is high, government agencies worldwide have implemented air quality alert programmes. Despite their widespread use, little is known about whether these programmes produce any observable public-health benefits. We assessed the effectiveness of such programmes using a quasi-experimental approach. METHODS: We assembled a population-based cohort comprising all individuals who resided in the city of Toronto (Ontario, Canada) from 2003 to 2012 (about 2·6 million people)...
January 2018: Lancet. Planetary Health
https://www.readbyqxmd.com/read/29584734/comorbidity-health-pathways-in-heart-failure-patients-a-sequences-of-regressions-analysis-using-cross-sectional-data-from-10-575-patients-in-the-swedish-heart-failure-registry
#17
Claire A Lawson, Ivonne Solis-Trapala, Ulf Dahlstrom, Mamas Mamas, Tiny Jaarsma, Umesh T Kadam, Anna Stromberg
BACKGROUND: Optimally treated heart failure (HF) patients often have persisting symptoms and poor health-related quality of life. Comorbidities are common, but little is known about their impact on these factors, and guideline-driven HF care remains focused on cardiovascular status. The following hypotheses were tested: (i) comorbidities are associated with more severe symptoms and functional limitations and subsequently worse patient-rated health in HF, and (ii) these patterns of association differ among selected comorbidities...
March 2018: PLoS Medicine
https://www.readbyqxmd.com/read/29564639/real-world-heart-failure-management-in-10-910-patients-with-chronic-heart-failure-in-the-netherlands-design-and-rationale-of-the-chronic-heart-failure-esc-guideline-based-cardiology-practice-quality-project-check-hf-registry
#18
J J Brugts, G C M Linssen, A W Hoes, H P Brunner-La Rocca
AIMS: Data from patient registries give insight into the management of patients with heart failure (HF), but actual data from unselected real-world HF patients are scarce. Therefore, we performed a cross sectional study of current HF care in the period 2013-2016 among more than 10,000 unselected HF patients at HF outpatient clinics in the Netherlands. METHODS: In 34 participating centres, all 10,910 patients with chronic HF treated at cardiology centres were included in the CHECK-HF registry...
March 21, 2018: Netherlands Heart Journal
https://www.readbyqxmd.com/read/29563785/excess-risk-of-major-vascular-diseases-associated-with-airflow-obstruction-a-9-year-prospective-study-of-0-5-million-chinese-adults
#19
Om P Kurmi, Liming Li, Kourtney J Davis, Jenny Wang, Derrick A Bennett, Ka Hung Chan, Ling Yang, Yiping Chen, Yu Guo, Zheng Bian, Junshi Chen, Liuping Wei, Donghui Jin, Rory Collins, Richard Peto, Zhengming Chen
Background: China has high COPD rates, even among never-regular smokers. Little is known about nonrespiratory disease risks, especially vascular morbidity and mortality after developing airflow obstruction (AFO) in Chinese adults. Objective: We aimed to investigate the prospective association of prevalent AFO with major vascular morbidity and mortality. Materials and methods: In 2004-2008, a nationwide prospective cohort study recruited 512,891 men and women aged 30-79 years from 10 diverse localities across China, tracking cause-specific mortality and coded episodes of hospitalization for 9 years...
2018: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29557669/telemonitoring-in-copd-the-chromed-study-a-randomized-clinical-trial
#20
Paul P Walker, Pasquale P Pompilio, Paolo Zanaboni, Trine S Bergmo, Kaiu Prikk, Andrei Malinovschi, Josep M Montserrat, Jo Middlemass, Silvana Šonc, Giulia Munaro, Dorjan Marušič, Ruth Sepper, Roberto Rosso, A Niroshan Siriwardena, Christer Janson, Ramon Farre, Peter M A Calverley, Raffaele L Dellaca'
RATIONALE: Early detection of COPD exacerbations using tele-monitoring of physiological variables might reduce the frequency of hospitalisation. OBJECTIVES: To evaluate the efficacy of home monitoring of lung mechanics by the forced oscillation technique (FOT) and cardiac parameters in older COPD patients with co-morbidities. METHODS: This multicentre, randomized clinical trial recruited 312 GOLD grade II-IV COPD patients (median age 71 years [IQR:66-76], 49...
March 20, 2018: American Journal of Respiratory and Critical Care Medicine
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