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https://www.readbyqxmd.com/read/28441856/-clinical-value-of-the-early-use-of-ulinastatin-in-patients-with-moderately-severe-or-severe-acute-pancreatitis
#1
J Wang, J Jin, J Huang, D R Li, Y Hao, J D Kong, Z Y Chu, J H Fu, F Huang
Objective: To observe the clinical efficacy and the effects on serum inflammatory factors of early use of ulinastatin in patients with moderately severe or severe acute pancreatitis (MSAP/SAP). Methods: This prospective, randomized, controlled trial was conducted in the First Affiliated Hospital of Soochow University from September 2013 to May 2016. A total of 42 cases were enrolled and assigned into either observation group or conventional treatment group (n=21 each). The conventional treatment group received somatostatin, while the observation group received somatostatin combined with ulinastatin...
April 25, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28441311/feasibility-and-outcome-of-an-accelerated-recovery-protocol-in-asian-adolescent-idiopathic-scoliosis-patients
#2
Chris Yin Wei Chan, Shweh Fern Loo, Jun Yin Ong, Kulathunga Arachchige Lisitha, M Shahnaz Hasan, Chee Kean Lee, Chee Kidd Chiu, Mun Keong Kwan
STUDY DESIGN: Prospective cohort study OBJECTIVE.: To determine the feasibility of an accelerated recovery protocol for Asian Adolescent Idiopathic Scoliosis (AIS) patients undergoing posterior spinal fusion (PSF). SUMMARY OF BACKGROUND DATA: There has been successful implementation of an accelerated recovery protocol for AIS patients undergoing PSF in the western population. No similar studies have been reported in the Asian population. METHODS: 74 AIS (65F, 9 M) patients scheduled for PSF surgery were recruited...
April 24, 2017: Spine
https://www.readbyqxmd.com/read/28441233/acute-respiratory-distress-syndrome-due-to-tuberculosis-in-a-respiratory-icu-over-a-16-year-period
#3
Valliappan Muthu, Sahajal Dhooria, Ashutosh N Aggarwal, Digambar Behera, Inderpaul Singh Sehgal, Ritesh Agarwal
OBJECTIVE: Whether tuberculosis-related acute respiratory distress syndrome is associated with worse outcomes when compared with acute respiratory distress syndrome secondary to other causes remains unknown. Herein, we compare the outcomes between the two groups. DESIGN: Retrospective analysis of all subjects admitted with acute respiratory distress syndrome over the last 16 years. SETTING: Respiratory ICU of a tertiary care hospital in North India...
April 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28441173/religiosity-in-acute-psychiatric-inpatients-relationship-with-demographics-clinical-features-and-length-of-stay
#4
Noha AbdelGawad, Jigar Chotalia, Ajay Parsaik, Teresa Pigott, Melissa Allen
This study examined the relationship between religiosity in 175 psychiatric inpatients as measured by the subscales of the Duke University Religion Index (DUREL) and sociodemographic (age, sex, and race), clinical (primary diagnosis, suicidality, and psychotic symptoms), and outcome (length of stay [LOS] and readmission rates) measures. Psychosis was assessed by Clinician-Rated Dimensions of Psychosis Symptom Severity (CRDPSS) scale. Bivariate and multivariate analyses were used to examine the association between the DUREL subscales and the outcome measures...
April 24, 2017: Journal of Nervous and Mental Disease
https://www.readbyqxmd.com/read/28440922/pseudomonas-aeruginosa-and-post-tracheotomy-bacterial-respiratory-tract-infection-readmissions
#5
Christopher J Russell, Tamara D Simon, Mary R Mamey, Christopher J L Newth, Michael N Neely
OBJECTIVE: Identify risk factors for readmission due to a bacterial tracheostomy-associated respiratory tract infection (bTARTI) within 12 months of discharge after tracheotomy. DESIGN/METHODS: We performed a retrospective cohort study of 240 children who underwent tracheotomy and were discharged with tracheotsomy in place between January 1, 2005 and June 30, 2013. Children with prolonged total or post-tracheotomy length of stay (LOS), less than 12 months of follow-up, or who died during the index hospitalization were excluded...
April 25, 2017: Pediatric Pulmonology
https://www.readbyqxmd.com/read/28440663/acupuncture-for-pain-and-nausea-in-the-intensive-care-unit-a-feasibility-study-in-a-public-safety-net-hospital
#6
Colin Feeney, Elizabeth Bruns, Gabrielle LeCompte, Anahita Forati, Thomas Chen, Amy Matecki
OBJECTIVES: To explore the feasibility and acceptability of providing acupuncture treatment to relieve pain and nausea symptoms in intensive care unit (ICU) patients. DESIGN: Prospective feasibility study. SETTINGS/LOCATION: Public safety net hospital with a 20-bed mixed medical/surgical ICU. SUBJECTS: Patients from all services admitted to the ICU from November 14, 2014 to April 2015. INTERVENTIONS: Three 20 min acupuncture treatments given for consented patients who were experiencing pain and/or nausea, in addition to usual care...
April 25, 2017: Journal of Alternative and Complementary Medicine: Research on Paradigm, Practice, and Policy
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/28439973/intracardiac-versus-transesophageal-echocardiography-to-guide-transcatheter-closure-of-interatrial-communications-nationwide-trend-and-comparative-analysis
#8
Fahad Alqahtani, Ashwin Bhirud, Sami Aljohani, James Mills, Akram Kawsara, Ashok Runkana, Mohamad Alkhouli
OBJECTIVES: This study aimed to assess current temporal trends in utilization of ICE versus TEE guided closure of interatrial communications, and to compare periprocedural complications and resource utilization between the two imaging modalities. BACKGROUND: While transesophageal echocardiography (TEE) has historically been used to guide percutaneous structural heart interventions, intracardiac echocardiography (ICE) is being increasingly utilized to guide many of these procedures such as closure of interatrial communications...
April 25, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28439356/impact-of-the-2003-acgme-resident-duty-hour-reform-on-hospital-acquired-conditions-a-national-retrospective-analysis
#9
Timothy Wen, Frank J Attenello, Steven Y Cen, Alexander A Khalessi, May Kim-Tenser, Nerses Sanossian, Steven L Giannotta, Arun P Amar, William J Mack
BACKGROUND: The Accreditation Council for Graduate Medical Education reforms in 2003 instituted an 80-hour weekly limit for resident physicians. Critics argue that these restrictions have increased handoffs among residents and the potential for a decline in patient safety. "Never events" hospital-acquired conditions (HACs) are a set of preventable events used as a quality metric in hospital safety analyses. OBJECTIVE: This analysis evaluated post-work hour reform effects on HAC incidence for US hospital inpatients, using the National Inpatient Sample...
April 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28439187/body-mass-index-and-intensive-care-unit-outcomes-in-african-american-patients
#10
O'Dene Lewis, Julius Ngwa, Angesom Kibreab, Marc Phillpotts, Alicia Thomas, Alem Mehari
PURPOSE: We sought to determine whether body mass index (BMI) is associated with worse intensive care unit (ICU) outcomes among Black patients. METHODS: Patients admitted to the medical ICU during 2012 were categorized into six BMI groups based on the World Health Organization criteria. ICU mortality, ICU and hospital length of stay (LOS), need for and duration of mechanical ventilation and organ failure rate were assessed. RESULTS: A total of 605 patients with mean age 58...
2017: Ethnicity & Disease
https://www.readbyqxmd.com/read/28439131/compliance-with-updated-sepsis-bundles-to-meet-new-sepsis-core-measure-in-a-tertiary-care-hospital
#11
Taylor H Ramsdell, April N Smith, Eric Kerkhove
Background: The updated Surviving Sepsis Campaign care bundles are associated with improved outcomes in patients with sepsis, yet adherence to the bundles remains inconsistent. The Centers for Medicare & Medicaid Services has adopted similar care bundles as a core measure that went into effect with October 1, 2015 discharges. Objective: The aim of this study was to assess bundle compliance, length of stay (LOS), and in-hospital mortality before and after introduction of the new sepsis core measure. Methods: A retrospective cohort study was conducted in 158 patients with a diagnosis of severe sepsis or septic shock from April 2015 to February 2016...
March 2017: Hospital Pharmacy
https://www.readbyqxmd.com/read/28438738/short-length-of-stay-after-elective-transfemoral-transcatheter-aortic-valve-replacement-is-not-associated-with-increased-early-or-late-readmission-risk
#12
Maneesh Sud, Feng Qui, Peter C Austin, Dennis T Ko, David Wood, Andrew Czarnecki, Vaidehi Patel, Douglas S Lee, Harindra C Wijeysundera
BACKGROUND: Elderly patients undergoing transcatheter aortic valve replacement (TAVR) are at risk of hospital readmission postprocedure. It is not known whether the index hospital length of stay and, specifically, early discharge post-TAVR is associated with an increased risk of readmission. We hypothesized a nonlinear relationship whereby both short and long lengths of stay were associated with increased readmission risk. METHODS AND RESULTS: We performed a retrospective multicenter cohort analysis of patients undergoing elective transfemoral TAVR and surviving to discharge between January 2007 and March 2014...
April 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28438453/effect-of-bundled-payments-and-health-care-reform-as-alternative-payment-models-in-total-joint-arthroplasty-a-clinical-review
#13
REVIEW
Ahmed Siddiqi, Peter B White, Jaydev B Mistry, Chukwuweike U Gwam, James Nace, Michael A Mont, Ronald E Delanois
BACKGROUND: In an effort to control rising healthcare costs, healthcare reforms have developed initiatives to evaluate the efficacy of alternative payment models (APMs) for Medicare reimbursements. The Center for Medicare and Medicaid Services Innovation Center (CMMSIC) introduced the voluntary Bundled Payments for Care Improvement (BPCI) model experiment as a means to curtail Medicare cost by allotting a fixed payment for an episode of care. The purpose of this review is to (1) summarize the preliminary clinical results of the BPCI and (2) discuss how it has led to other healthcare reforms and alternative payment models...
March 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28438450/monocryl-and-dermabond-vs-staples-in-total-hip-arthroplasty-performed-through-a-lateral-skin-incision-a-randomized-controlled-trial-using-a-patient-centered-assessment-tool
#14
Raymond A Glennie, Abigail Korczak, Douglas D Naudie, Dianne M Bryant, James L Howard
BACKGROUND: There are various possible methods of skin closure in total hip arthroplasty (THA) through a lateral skin incision. The cost and time required for each can vary between techniques. The objective of this study was to determine whether there is a difference in patient and surgeon rating of scar outcome using a combination of subcuticular suture and skin adhesive (subcuticular MONOCRYL and DERMABOND [SMD]) vs staples for skin closure after THA. METHODS: Patients undergoing THA were recruited from a university hospital...
February 24, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28438417/comparing-hospital-outcomes-between-open-and-closed-tibia-fractures-treated-with-intramedullary-fixation
#15
Evan J Smith, Xiangyu Kuang, Rajeev Pandarinath
INTRODUCTION: Tibial shaft fractures comprise a large portion of operatively treated long bone fractures, and present with the highest rate of open injuries. Intramedullary fixation has become the standard of care for both open and closed injuries. The rates of short term complications and hospital length of stay for open and closed fractures treated with intramedullary fixation is not fully known. Previous series on tibia fractures were performed at high volume centers, and data were not generalizable, further they did not report on length of stay and the impact of preoperative variables on infections, complications and reoperation...
March 30, 2017: Injury
https://www.readbyqxmd.com/read/28438400/arteriotomy-closure-devices-in-evar-tevar-and-tavr-a-systematic-review-and-meta-analysis-of-randomised-clinical-trials-and-cohort-studies
#16
REVIEW
B P Vierhout, R A Pol, M El Moumni, C J Zeebregts
OBJECTIVES: Cardiac and vascular surgery benefit from percutaneous interventions. Arteriotomy closure devices (ACDs) enable minimally invasive access to the common femoral artery (CFA). The objective of this review was to assess the differences between ACDs and surgical cut down (SCD) of the CFA regarding the number of complications, duration of surgery (DOS), and hospital length of stay (HLOS). DESIGN: A systematic literature search with predefined search terms was performed using MEDLINE, Embase, and the Cochrane Library (2000-2016)...
April 21, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28438261/the-affordable-care-act-and-its-association-with-length-of-stay-and-payer-status-for-trauma-patients-at-a-level-i-trauma-center
#17
Vicente Jose Undurraga Perl, Chris Dodgion, Kyle Hart, Bruce Ham, Martin Schreiber, David Zonies
BACKGROUND: We hypothesized that the ACA would shorten length of stay and increase numbers of insured patients without changing trauma patient outcomes. METHODS: A retrospective review of adult trauma patients admitted to a level I trauma center between 2012 and 2014 was performed. Demographics, length of stay, payer status, discharge disposition, and complications before and after the ACA implementation were analyzed. RESULTS: 4448 trauma patients were admitted during the study period...
April 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28438104/impact-of-a-scribe-program-on-patient-throughput-physician-productivity-and-patient-satisfaction-in-a-community-based-emergency-department
#18
Waqas Shuaib, John Hilmi, Joshua Caballero, Ijaz Rashid, Hashim Stanazai, Kerolos Tawfeek, Ahmed Amari, Alan Ajanovic, Alex Moshtaghi, Anjit Khurana, Hesham Hasabo, Abdulrehman Baqais, Arthur J Szczerba, Theodore J Gaeta
Previous literature on the impact of scribe programs varies and has mostly been reported from academic institutions or other clinics. We report the implementation of the scribe program in the emergency room of a community hospital and its impact on patient throughput, physician productivity, and patient satisfaction. We performed a quasi-experimental, before-and-after study measuring patient throughput metrics, physician productivity, and patient satisfaction. The intervention measuring the scribe implementation was divided into pre- and post-implementation periods...
April 1, 2017: Health Informatics Journal
https://www.readbyqxmd.com/read/28437582/modified-frailty-index-predicts-postoperative-outcomes-in-older-gastrointestinal-cancer-patients
#19
Sarah A Vermillion, Fang-Chi Hsu, Robert D Dorrell, Perry Shen, Clancy J Clark
BACKGROUND AND OBJECTIVES: Frailty disproportionately impacts older patients with gastrointestinal cancer, rendering them at increased risk for poor outcomes. A frailty index may aid in preoperative risk stratification. We hypothesized that high modified frailty index (mFI) scores are associated with adverse outcomes after tumor resection in older, gastrointestinal cancer patients. METHODS: Patients (60-90 years old) who underwent gastrointestinal tumor resection were identified in the 2005-2012 NSQIP Participant Use File...
April 24, 2017: Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28437506/treatment-of-unstable-trochanteric-femur-fractures-proximal-femur-nail-versus-proximal-femur-locking-compression-plate
#20
Ashutosh Kumar Singh, Nidi Narsaria, Arun G R, Vivek Srivastava
Unstable trochanteric femur fractures are common fractures that are difficult to manage. We conducted a prospective study to compare functional outcomes and complications of 2 different implant designs, proximal femur nail (PFN) and proximal femur locking compression plate (PFLCP), used in internal fixation of unstable trochanteric femur fractures. On hospital admission, 48 patients with unstable trochanteric fractures were randomly assigned (using a sealed envelope method) to treatment with either PFN (24 patients) or PFLCP (24 patients)...
March 2017: American Journal of Orthopedics
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