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https://www.readbyqxmd.com/read/28528282/management-options-in-the-treatment-of-femoral-pseudoaneurysms-secondary-to-intravenous-drug-abuse-a-case-series
#1
James Rammell, Nisheeth Kansal, Vish Bhattacharya
INTRODUCTION: Infected femoral pseudoaneurysms are a common presentation in intravenous drug users with little consensus as to the optimum management of these patients. Whilst emergency revascularisation options are available, excision and ligation of the femoral artery remains the most common operative intervention but risks leaving the patient with critical ischaemia or intermittent claudication. This case series reviewed the outcomes of 4 patients who underwent excision-ligation without revascularisation of an infected femoral pseudoaneurysm at a district general hospital...
May 5, 2017: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/28526917/do-we-know-the-outcome-predictors-for-cauda-equine-syndrome-ces-a-retrospective-single-center-analysis-of-60-patients-with-ces-with-a-suggestion-for-a-new-score-to-measure-severity-of-symptoms
#2
Alexander König, Lisa Amelung, Marco Danne, Ullrich Meier, Johannes Lemcke
OBJECTIVE: Despite the awareness and familiarity of almost every medical professional with the cauda equine compression syndrome (CES), risk factors for a poor prognosis of the disease remain elusive. Even the relationship between subsequent outcome and the time elapsed from the time of appearance of symptoms to surgery taking place remain obscure. The aim of our study, therefore, was to analyze a relatively large population of our own patients studied consecutively, to identify outcome predictors for CES and to propose a clinical score for CES symptoms (Berlin CES score)...
May 19, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28526311/dramatic-effects-of-a-new-antimicrobial-stewardship-program-in-a-rural-community-hospital
#3
Claudia R Libertin, Stephanie H Watson, William L Tillett, Joy H Peterson
BACKGROUND: New Joint Commission antimicrobial stewardship requirements took effect on January 1, 2017, promoted as a central strategy for coping with the emerging problems of antimicrobial resistance and Clostridium difficile infection. Our objective was to measure the effects of a new antimicrobial stewardship program (ASP) in a rural community hospital with no prior ASP, in the context of having a new infectious disease specialist on staff. METHODS: An ASP team was formed to implement a prospective audit with health care provider feedback and targeting 12 antimicrobial agents in a rural hospital in Georgia...
May 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28521746/survival-rates-and-predictors-of-survival-among-colorectal-cancer-patients-in-a-malaysian-tertiary-hospital
#4
Bello Arkilla Magaji, Foong Ming Moy, April Camilla Roslani, Chee Wei Law
BACKGROUND: Colorectal cancer is the third most commonly diagnosed malignancy and the fourth leading cause of cancer-related death globally. It is the second most common cancer among both males and females in Malaysia. The economic burden of colorectal cancer is likely to increase over time owing to its current trend and aging population. Cancer survival analysis is an essential indicator for early detection and improvement in cancer treatment. However, there was a scarcity of studies concerning survival of colorectal cancer patients as well as its predictors...
May 18, 2017: BMC Cancer
https://www.readbyqxmd.com/read/28515604/development-and-psychometric-evaluation-of-the-pre-hospital-medical-emergencies-early-warning-scale
#5
Abbasali Ebrahimian, Gholamreza Masoumi, Roohangiz Jamshidi-Orak, Hesam Seyedin
INTRODUCTION: The number of requests for emergency medical services (EMSs) has increased during the past decade. However, most of the transports are not essential. Therefore, it seems crucial to develop an instrument to help EMS staff accurately identify patients who need pre-hospital care and transportation. The aim of this study was to develop and evaluate the psychometric properties of the Pre-hospital Medical Emergencies Early Warning Scale (Pre-MEWS). MATERIALS AND METHODS: This mixed-method study was conducted in two phases...
April 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28513518/firearm-injuries-received-in-emergency-room-of-a-nigerian-teaching-hospital-aanalysis-of-pattern-morbidity-and-mortality
#6
N I Omoke
BACKGROUND: The morbidity and mortality associated with civilian firearm injury in developing countries is appreciable. The increasing incidence of gunshot casualties received in hospital emergency rooms is an emerging concern. The aim of this study was to determine the pattern and outcome of firearm injuries in a civilian setting of a developing country. MATERIALS AND METHOD: This was a retrospective analysis of data on the entire patients with firearm injury received in the emergency room of Federal Teaching Hospital Abakaliki from January 2005 to December 2014...
May 2017: Nigerian Journal of Clinical Practice
https://www.readbyqxmd.com/read/28513357/nursing-students-experience-of-research-during-clinical-placements
#7
Claire Louise Whitehouse
Aim To investigate pre-registration nursing students' experience of research during clinical placements, and to identify any positive aspects or barriers to gaining experience of research during clinical placements. Method Qualitative, phenomenological, semi-structured interviews were undertaken with preregistration degree-level nursing students. The students were attending one university in the east of England, and were on clinical placements at one of three hospital sites in two trusts. Data were reviewed using thematic analysis...
May 17, 2017: Nursing Standard
https://www.readbyqxmd.com/read/28504487/haemophilus-influenzae-type-b-meningitis-is-there-a-re-emergence-24-years-of-experience-in-a-children-s-hospital
#8
Angela Gentile, Ana C Martínez, María Del V Juarez, María F Lución, Candela Burgo, María P Della Latta, Solana Rapapor, Viviana Romanin, Marisa Turco
INTRODUCTION: Haemophilus influenzae type B (Hib) used to be the main cause of bacterial meningitis in children younger than 5 years old. Following the introduction of the Hib vaccine in the immunization schedule (1998), its incidence reduced significantly but it has increased over the last years. The objectives of this study included describing the characteristics and analyzing the epidemic curve of Haemophilus influenzae type B (Hib) meningitis by comparing the pre- and postimmunization periods...
June 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28499510/effect-of-policy-change-on-the-use-of-long-distance-transport-and-follow-up-care-for-patients-with-traumatic-finger-amputations
#9
Michael T Nolte, Melissa J Shauver, Kevin C Chung, Aviram M Giladi
PURPOSE: In January 2006, the American College of Emergency Physicians released updated guidelines for air transfer. Digit amputation and near-amputation were no longer an indication for this costly service. We analyzed the effect of this update on the use of air transport and associated care outcomes for finger amputation patients and examined factors involved in providing follow-up care for these patients. METHODS: A retrospective chart review identified all patients treated for traumatic finger amputation between 1995 and 2012 at a major hand trauma referral center...
May 9, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/28499459/dispatch-and-prehospital-transport-for-acute-septic-patients-an-observational-study
#10
Peter Bank Pedersen, Daniel Pilsgaard Henriksen, Søren Mikkelsen, Annmarie Touborg Lassen
BACKGROUND: In order to dispatch ambulances with the correct level of urgency, the dispatch center has to balance the perceived urgency and traffic safety considerations with the available resources. As urgency is not clear in all clinical situations, some high urgency patients may end up with a suboptimal mode of transport. Patients with severe sepsis or septic shock suffer from highly time dependent conditions but they present with a wide range of symptoms, which might be difficult to identify in the dispatch system...
May 12, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28499358/can-we-predict-functional-decline-in-hospitalized-older-people-admitted-through-the-emergency-department-reanalysis-of-a-predictive-tool-ten-years-after-its-conception
#11
Isabelle De Brauwer, Pascale Cornette, Benoît Boland, Franck Verschuren, William D'Hoore
BACKGROUND: In the Emergency Department (ED), early and rapid identification of older people at risk of adverse outcomes, who could best benefit from complex geriatric intervention, would avoid wasting time, especially in terms of prevention of adverse outcomes, and ensure optimal orientation of vulnerable patients. We wanted to test the predictive ability of a screening tool assessing risk of functional decline (FD), named SHERPA, 10 years after its conception, and to assess the added value of other clinical or biological factors associated with FD...
May 12, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28498904/the-acef-ii-risk-score-for-cardiac-surgery-updated-but-still-parsimonious
#12
Marco Ranucci, Valeria Pistuddi, Sabino Scolletta, Carlo de Vincentiis, Lorenzo Menicanti
Aims: The age, creatinine, and ejection fraction (ACEF) score was introduced in 2009 and is presently included in the guidelines for myocardial revascularization of the European Society of Cardiology and Association for Cardio-Thoracic Surgery as a risk stratification tool for surgical and percutaneous myocardial revascularization. The present study introduces an updated version of the ACEF (ACEF II) inclusive of emergency surgery and pre-operative anaemia. Methods and results: The development series includes 7011 consecutive cardiac surgery patients operated at a single institution...
May 12, 2017: European Heart Journal
https://www.readbyqxmd.com/read/28498094/predictors-of-all-cause-30-day-readmission-among-medicare-patients-with-type-2-diabetes
#13
Jenna Collins, Ibrahim M Abbass, Raymond Harvey, Brandon Suehs, Claudia Uribe, Jonathan Bouchard, Todd Prewitt, Tony DeLuzio, Elsie Allen
OBJECTIVE: Readmission is costly among patients with type 2 diabetes (T2DM) in Medicare Advantage Prescription Drug Plans; identifying high-risk patients is necessary for targeting reduction programs. The objective of this study was to develop a claims-based algorithm to predict all-cause 30-day readmission among patients with T2DM. METHODS: This study used administrative data from 1/1/2012 through 1/31/2014. The cohort included hospitalized T2DM patients, aged 18-90 with ≥12 months' continuous-enrollment before an unplanned hospital admission and ≥1 month of enrollment post-discharge, excluding patients in long-term care >30 days pre-index...
May 12, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28496344/adherence-to-disease-modifying-therapies-and-its-impact-on-relapse-health-resource-utilization-and-costs-among-patients-with-multiple-sclerosis
#14
Jack Burks, Thomas S Marshall, Xiaolan Ye
PURPOSE: To evaluate adherence to disease-modifying therapies (DMTs) among patients with multiple sclerosis (MS) initiating oral and injectable DMTs, and to estimate the impact of adherence on relapse, health resource utilization, and medical costs. PATIENTS AND METHODS: Commercially insured MS patients (aged 18-65 years, two or more MS diagnoses, one or more DMT claims) with continuous eligibility 12 months before and after the first DMT claim date (index date) and no DMT claim during the pre-index period were identified from a large commerical claims database for the period from January 1, 2008, to September 30, 2015...
2017: ClinicoEconomics and Outcomes Research: CEOR
https://www.readbyqxmd.com/read/28495487/effect-of-psychiatric-illness-on-acute-care-utilization-at-end-of-life-from-serious-medical-illness
#15
Kyle Lavin, Dimitry S Davydow, Lois Downey, Ruth A Engelberg, Ben Dunlap, James Sibley, William B Lober, Kelson Okimoto, Nita Khandelwal, Elizabeth T Loggers, Joan M Teno, J Randall Curtis
CONTEXT: Little is known about psychiatric illness and utilization of end-of-life care. OBJECTIVES: We hypothesized that pre-existing psychiatric illness would increase hospital utilization at end-of-life among patients with chronic medical illness due to increased severity of illness and care fragmentation. METHODS: We reviewed electronic health records to identify decedents with one or more of eight chronic medical conditions based on International Classification of Diseases (ICD)-9 codes...
May 8, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28495031/a-pilot-mobile-integrated-healthcare-program-for-frequent-utilizers-of-emergency-department-services
#16
Vicki A Nejtek, Subhash Aryal, Deepika Talari, Hao Wang, Liam O'Neill
PURPOSE: To examine whether or not a mobile integrated health (MIH) program may improve health-related quality of life while reducing emergency department (ED) transports, ED admissions, and inpatient hospital admissions in frequent utilizers of ED services. METHODS: A small retrospective evaluation assessing pre- and post-program quality of life, ED transports, ED admissions, and inpatient hospital admissions was conducted in patients who frequently used the ED for non-emergent or emergent/primary care treatable conditions...
April 27, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28494475/impact-of-a-national-time-target-for-ed-length-of-stay-on-patient-outcomes
#17
Peter Jones, Susan Wells, Alana Harper, James Le Fevre, Joanna Stewart, Elana Curtis, Papaarangi Reid, Shanthi Ameratunga
AIM: The impact of national targets for emergency department (ED) length of stay (LOS) on patient care is unclear. This study aimed to determine the effect of New Zealand's six-hour time target (95% of ED patients discharged or admitted to hospital within six hours) on a range of quality indicators. METHODS: A nationwide observational study from 2006 to 2012 modelled differences in changes over time before and after target introduction in 2009. The observed model estimates in 2012 were compared to those predicted if pre-target trends had continued...
May 12, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28494390/bipolar-patients-treated-with-long-acting-injectable-risperidone-in-taiwan-a-1-year-mirror-image-study-using-a-national-claims-database
#18
Ming H Hsieh, Po-Ya Chuang, Chi-Shin Wu, Ching-Jui Chang, Pei-Fang Chung, Chao-Hsiun Tang
OBJECTIVE: Bipolar disorder (BD) is burdensome for patients and healthcare systems. This study evaluated changes in concomitant medication patterns, healthcare utilization, and costs after the initiation of risperidone long-acting injection (RLAI) treatment among BD patients. METHOD: 287 BD patients receiving regular RLAI treatment for 1 year were identified from the Taiwan National Health Insurance Research database during 2007-2012. The bootstrapping procedure was performed to create 1000 samples to generate normally distributed data...
May 3, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28492816/enhanced-recovery-after-surgery-program-implementation-in-2-surgical-populations-in-an-integrated-health-care-delivery-system
#19
Vincent X Liu, Efren Rosas, Judith Hwang, Eric Cain, Anne Foss-Durant, Molly Clopp, Mengfei Huang, Derrick C Lee, Alex Mustille, Patricia Kipnis, Stephen Parodi
Importance: Novel approaches to perioperative surgical care focus on optimizing nutrition, mobility, and pain management to minimize adverse events after surgical procedures. Objective: To evaluate the outcomes of an enhanced recovery after surgery (ERAS) program among 2 target populations: patients undergoing elective colorectal resection and patients undergoing emergency hip fracture repair. Design, Setting, and Participants: A pre-post difference-in-differences study before and after ERAS implementation in the target populations compared with contemporaneous surgical comparator groups (patients undergoing elective gastrointestinal surgery and emergency orthopedic surgery)...
May 10, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28489813/implementing-a-novel-model-for-hospice-and-palliative-care-in-the-emergency-department-an-experience-from-a-tertiary-medical-center-in-taiwan
#20
Tzu-Chieh Weng, Ya-Chun Yang, Ping-Jen Chen, Wen-Fu Kuo, Wei-Lin Wang, Ya-Ting Ke, Chien-Chin Hsu, Kao-Chang Lin, Chien-Cheng Huang, Hung-Jung Lin
Hospice and palliative care has been recognized as an essential part of emergency medicine; however, there is no consensus on the optimal model for the delivery of hospice and palliative care in the emergency department (ED). Therefore, we conducted a novel implementation in a tertiary medical center in Taiwan. In the preintervention period, we recruited a specialist for hospice and palliative medicine in the ED to lead our intervention. In the early stage of the intervention, starting on July 1, 2014, we encouraged and funded ED physicians and nurses to receive training for hospice and palliative medicine and residents of emergency medicine to rotate to the hospice ward...
May 2017: Medicine (Baltimore)
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