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https://www.readbyqxmd.com/read/28339695/incidence-and-outcomes-of-infections-caused-by-multidrug-resistant-enterobacteriaceae-in-children-2007-2015
#1
Sharon B Meropol, Allison A Haupt, Sara M Debanne
Background.: The escalating incidence of invasive disease caused by multidrug-resistant Gram-negative enteric Enterobacteriaceae (MDR-GNE) is a global concern. Scant published studies in which the epidemiology of these infections in children is described exist; previous studies focused mainly on adults, described circumscribed populations, or lacked clinical detail. The objective of this study was to examine and describe the incidence, risk factors, and outcomes associated with MDR-GNE infection in children...
February 22, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28339511/living-alone-and-unplanned-hospitalizations-among-older-adults-a-population-based-longitudinal-study
#2
Clément Pimouguet, Debora Rizzuto, Marten Lagergren, Laura Fratiglioni, Weili Xu
The association of living alone with hospitalization among the general elderly population has been rarely investigated, and the influence of common disorders on this association remains unknown. We used data on participants in the Swedish National study on Aging and Care in Kungsholmen ( n = 3130). Risk and number of unplanned hospitalizations and length of hospital stays were studied over a period of 2 years. We used Cox proportional hazard models to estimate hazard ratios (HRs) of incident hospitalization and zero-inflated negative binomial regression models adjusted for potential confounders to estimate incident rate ratios (IRR) of the number of hospitalizations and total length of stay associated with living alone...
October 15, 2016: European Journal of Public Health
https://www.readbyqxmd.com/read/28339314/an-analysis-of-ems-and-ed-detection-of-stroke
#3
Ian Medoro, David C Cone
BACKGROUND AND PURPOSE: Studies have shown a reduction in time-to-CT and improved process measures when EMS personnel notify the ED of a "stroke alert" from the field. However, there are few data on the accuracy of these EMS stroke alerts. The goal of this study was to examine diagnostic test performance of EMS and ED stroke alerts and related process measures. METHODS: The EMS and ED records of all stroke alerts in a large tertiary ED from August 2013-January 2014 were examined and data abstracted by one trained investigator, with data accuracy confirmed by a second investigator for 15% of cases...
March 24, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28339159/differences-in-survival-outcome-for-severely-injured-paediatric-trauma-by-type-of-trauma-centre
#4
Rebecca J Mitchell, Kate Curtis, Luke Testa, Andrew Ja Holland, Soundappan Sv Soundappan, Sarah Adams
AIM: Whether treatment at paediatric trauma centres (PTCs) provides a survival advantage for injured children over treatment at adult trauma centres (ATCs) remains inconclusive. This study examines the association between trauma centre type and in-hospital mortality for severely injured paediatric trauma patients in New South Wales, Australia. METHODS: A retrospective examination of paediatric patient characteristics (aged ≤15 years), treatment and injury outcome was conducted using data from the New South Wales Trauma Registry for 2009-2014...
March 24, 2017: Journal of Paediatrics and Child Health
https://www.readbyqxmd.com/read/28338808/the-relationship-between-cognitive-impairment-mortality-and-discharge-characteristics-in-a-large-cohort-of-older-adults-with-unscheduled-admissions-to-an-acute-hospital-a-retrospective-observational-study
#5
Carole Fogg, Paul Meredith, Jackie Bridges, Gill P Gould, Peter Griffiths
Background: older people with dementia admitted to hospital for acute illness have higher mortality and longer hospital stays compared to those without dementia. Cognitive impairment (CI) is common in older people, and they may also be at increased risk of poor outcomes. Methods: retrospective observational study of unscheduled admissions aged ≥75 years. Admission characteristics, mortality rates and discharge outcomes were compared between three groups: (i) known dementia diagnosis (DD), (ii) CI but no diagnosis of dementia and (iii) no CI...
February 25, 2017: Age and Ageing
https://www.readbyqxmd.com/read/28338553/consequences-of-hybrid-procedure-addition-to-robotic-assisted-direct-coronary-artery-bypass
#6
Feras Khaliel, Vincenzo Giambruno, Michael W A Chu, Kumar Sridhar, Patrick Teefy, Bob B Kiaii
OBJECTIVE: Patients postcoronary artery revascularization surgery often receives blood product transfusion, which could delay their intensive care unit and hospital discharge. We investigated our robotic-assisted direct coronary artery bypass (RADCAB) transfusion rate to determine whether performing the minimal invasive coronary surgery with percutaneous coronary intervention in one stage would increase the incidence of blood transfusion, morbidity, and length of stay. METHODS: Between November 2003 and November 2015, 483 consecutive patients underwent RADCAB surgery...
March 23, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28338551/standardizing-robotic-lobectomy-feasibility-and-safety-in-128-consecutive-lobectomies-within-a-single-healthcare-system
#7
John F Lazar, Laurence N Spier, Alan R Hartman, Richard S Lazzaro
OBJECTIVE: Single-surgeon cohorts assessing robotically assisted video-assisted thoracic (RA-VATS) lobectomy have reported good outcomes, but there are little data regarding multiple surgeons applying a standard technique in separate hospitals. The purpose of this study was to show how a standardized robotic technique is both safe and reproducible between surgeons and institutions. METHODS: From July 1, 2012, to October 1, 2013, patients undergoing RA-VATS lobectomy for both benign and malignant disease were identified from a prospectively collected database of two thoracic surgeons from different hospitals within the same healthcare system and retrospectively analyzed...
March 23, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28338533/sepsis-patients-in-the-emergency-department-stratification-using-the-clinical-impression-score-predisposition-infection-response-and-organ-dysfunction-score-or-quick-sequential-organ-failure-assessment-score
#8
Vincent M Quinten, Matijs van Meurs, Anna E Wolffensperger, Jan C Ter Maaten, Jack J M Ligtenberg
OBJECTIVE: The aim of this study was to compare the stratification of sepsis patients in the emergency department (ED) for ICU admission and mortality using the Predisposition, Infection, Response and Organ dysfunction (PIRO) and quick Sequential Organ Failure Assessment (qSOFA) scores with clinical judgement assessed by the ED staff. PATIENTS AND METHODS: This was a prospective observational study in the ED of a tertiary care teaching hospital. Adult nontrauma patients with suspected infection and at least two Systemic Inflammatory Response Syndrome criteria were included...
March 23, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28338517/improving-nutritional-support-of-burn-service-patients-by-increasing-the-number-of-days-when-100-of-prescribed-formula-is-given
#9
Peggie F Conrad, Julie Liberio, Razia Aleem, Marcia M Halerz, Michael J Mosier, Arthur P Sanford, Richard L Gamelli
The authors sought to increase the number of days when burn service patients receive 100% of prescribed enteral nutrition. The authors first performed a retrospective review of 37 patients (group 1) receiving enteral nutrition. The authors then created and implemented a nurse-directed feeding algorithm, placing patients into three age groups addressing maximum hourly infusion rates, high residual limits, initiating feeding, refeeding residuals, and replacing formula. The authors then performed a prospective review of 37 patients (group 2) fed utilizing the new algorithm...
March 21, 2017: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/28338497/using-selective-serotonin-reuptake-inhibitors-and-serotonin-norepinephrine-reuptake-inhibitors-in-critical-care-a-systematic-review-of-the-evidence-for-benefit-or-harm
#10
John M Kelly, Gordon D Rubenfeld, Neil Masson, Arimie Min, Neill K J Adhikari
OBJECTIVE: Selective serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitors are among the most commonly prescribed drugs in patients admitted to the ICU. Our objective was to systematically review available literature for evidence of benefit or harm in ICU patients resulting from chronic effects, continued use, or withdrawal. DATA SOURCES: Medline, Embase, and Cochrane Central Register of Controlled Trials (1990 to November 2014). STUDY SELECTION: We searched for studies of ICU patients with recorded selective serotonin reuptake inhibitor/serotonin-norepinephrine reuptake inhibitor prescription before or during admission, and reporting morbidity, mortality, adverse events, and resource measures like ICU length of stay...
March 23, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28338483/prevalence-and-impact-on-weaning-of-pleural-effusion-at-the-time-of-liberation-from-mechanical-ventilation-a-multicenter-prospective-observational-study
#11
Martin Dres, Damien Roux, Tài Pham, Alexandra Beurton, Jean-Damien Ricard, Muriel Fartoukh, Alexandre Demoule
BACKGROUND: Pleural effusion is frequent in intensive care unit patients, but its impact on the outcome of weaning remains unknown. METHODS: In a prospective study performed in three intensive care units, pleural ultrasound was performed at the first spontaneous breathing trial to detect and quantify pleural effusion (small, moderate, and large). Weaning failure was defined by a failed spontaneous breathing trial and/or extubation requiring any form of ventilatory support within 48 h...
March 24, 2017: Anesthesiology
https://www.readbyqxmd.com/read/28336249/current-epidemiology-of-revision-total-hip-arthroplasty-in-the-united-states-national-inpatient-sample-2009-to-2013
#12
Chukwuweike U Gwam, Jaydev B Mistry, Nequesha S Mohamed, Melbin Thomas, Kevin C Bigart, Michael A Mont, Ronald E Delanois
BACKGROUND: Despite the excellent outcomes associated with primary total hip arthroplasty (THA), implant failure and revision continues to burden the healthcare system. THA failure has evolved and displays variability throughout the literature. In order to understand how THAs are failing and how to reduce this burden, it is essential to assess modes of implant failure on a large scale. Thus, we report: (1) etiologies for revision THA; (2) frequencies of revision THA procedures; (3) patient demographics, payor type, and US Census region of revision THA patients; and (4) the length of stay and total costs based on the type of revision THA procedure...
February 27, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28336148/preoperative-body-mass-index-and-physical-function-are-associated-with-length-of-stay-and-facility-discharge-after-total-knee-arthroplasty
#13
Matthew G Prohaska, Benjamin J Keeney, Haaris A Beg, Ishaan Swarup, Wayne E Moschetti, Stephen R Kantor, Ivan M Tomek
BACKGROUND: Hospital length of stay (LOS) and facility discharge are primary drivers of the cost of total knee arthroplasty (TKA). We sought to identify modifiable patient factors that were associated with increased LOS and facility discharge after TKA. METHODS: Prospective data were reviewed from 716 consecutive, primary TKA procedures performed by two arthroplasty surgeons between 2006 and 2012 at a single institution. Preoperative body mass index (BMI), Veterans RAND-12 (VR-12) physical component score (PCS), and hemoglobin level were collected in addition to other adjusters...
March 20, 2017: Knee
https://www.readbyqxmd.com/read/28335987/community-health-indicators-associated-with-outcomes-of-pancreatectomy
#14
Lauren Slakey Pointer, Zaid Al-Qurayshi, David Taylor Pointer, Emad Kandil, Douglas Philip Slakey
PURPOSE: This study evaluates the association of environmental, social and health risk factors in relation to outcomes of pancreatic surgery. METHODS: Patients who underwent pancreatectomy with a 30 day postoperative follow up in Florida, New York and Washington states were identified using the State Inpatient Databases (SID) from 2010 to 2011. This data was merged with community health indicators complied from the County Health Ranking database. Fourteen community health indicators were used to determine higher risk communities...
March 10, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28335653/anesthesia-management-of-complete-versus-incomplete-placenta-previa-a-retrospective-cohort-study
#15
Sharon Orbach-Zinger, Carolyn F Weiniger, Amir Aviram, Alexander Balla, S Fein, L A Eidelman, A Ioscovich
PURPOSE: Placenta previa (PP) is a major cause of obstetric hemorrhage. Clinical diagnosis of complete versus incomplete PP has a significant impact on the peripartum outcome. Our study objective is to examine whether distinction between PP classifications effect anesthetic management. METHODS AND MATERIALS: This multi center, retrospective, cohort study was performed in two tertiary university-affiliated medical centers between the years 2005- 2013. Electronic delivery databases were reviewed for demographic, anesthetic, obstetric hemorrhage, and postoperative outcomes for all cases...
March 23, 2017: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28335616/predictors-of-cd4-health-and-viral-suppression-outcomes-for-formerly-homeless-people-living-with-hiv-aids-in-scattered-site-supportive-housing
#16
Elizabeth A Bowen, James Canfield, Suzanne Moore, Midge Hines, Brent Hartke, Chrissy Rademacher
Stable housing is key to improving health outcomes for people living with HIV/AIDS. Though many formerly homeless HIV positive individuals reside in supportive housing, little research has examined biometric HIV health outcomes for residents of these programs. Through a community-based research partnership, this study analyzed secondary data from a Shelter Plus Care supportive housing program in Cincinnati, Ohio to examine the likelihood of participants achieving a healthy CD4 count (>500 cells/mm(3)) and viral suppression (viral load <200 copies/mL) while in supportive housing and to identify participant characteristics associated with these outcomes...
March 23, 2017: AIDS Care
https://www.readbyqxmd.com/read/28335580/the-development-of-psychiatric-services-providing-an-alternative-to-full-time-hospitalization-is-associated-with-shorter-length-of-stay-in-french-public-psychiatry
#17
Coralie Gandré, Jeanne Gervaix, Julien Thillard, Jean-Marc Macé, Jean-Luc Roelandt, Karine Chevreul
International recommendations for mental health care have advocated for a reduction in the length of stay (LOS) in full-time hospitalization and the development of alternatives to full-time hospitalizations (AFTH) could facilitate alignment with those recommendations. Our objective was therefore to assess whether the development of AFTH in French psychiatric sectors was associated with a reduction in the LOS in full-time hospitalization. Using data from the French national discharge database of psychiatric care, we computed the LOS of patients admitted for full-time hospitalization...
March 21, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28333302/outcomes-of-multisite-antimicrobial-stewardship-programme-implementation-with-a-shared-clinical-decision-support-system
#18
Stuart E Bond, Adriana J Chubaty, Suman Adhikari, Spiros Miyakis, Craig S Boutlis, Wilfred W Yeo, Marijka J Batterham, Cara Dickson, Brendan J McMullan, Mona Mostaghim, Samantha Li-Yan Hui, Kate R Clezy, Pamela Konecny
Background: Studies evaluating antimicrobial stewardship programmes (ASPs) supported by computerized clinical decision support systems (CDSSs) have predominantly been conducted in single site metropolitan hospitals. Objectives: To examine outcomes of multisite ASP implementation supported by a centrally deployed CDSS. Methods: An interrupted time series study was conducted across five hospitals in New South Wales, Australia, from 2010 to 2014...
March 14, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28332921/leaving-the-skin-incision-open-may-not-be-as-beneficial-as-we-have-been-taught
#19
Jack C He, Brenda M Zosa, David Schechtman, Brian Brajcich, Jonathan C Savakus, Amanda L Wojahn, Derek Z Wang, Jeffrey A Claridge
BACKGROUND: Currently, various methods of skin closures are used in contaminated and dirty abdominal wounds without solid, evidence-based guidance. This study investigates whether closure methods affect surgical site infection (SSI) and other incisional complications. We hypothesize that open management of the skin would have the lowest complications, including SSI. PATIENTS AND METHODS: Patients age ≥18 who underwent trauma laparotomy (TL) or damage control laparotomy (DCL) from 2008-2013 and had class III/IV wounds were included...
March 23, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28332075/roux-en-y-gastric-bypass-following-nissen-fundoplication-higher-risk-same-reward
#20
Michael D Watson, J Hunter Mehaffey, Bruce D Schirmer, Peter T Hallowell
BACKGROUND: Roux-en-Y gastric bypass (RYGB) effectively treats obesity and gastroesophageal reflux disease (GERD). As more surgeons recommend RYGB to treat GERD in patients with obesity, there are concerns about this approach in patients with previous non-bariatric foregut surgery. This study aims to evaluate the effect of previous non-bariatric foregut surgery on subsequent RYGB. METHODS: Retrospective review of 2089 patients undergoing RYGB between January 1985 and June 2015 was conducted to identify all patients with previous non-bariatric foregut surgery...
March 22, 2017: Obesity Surgery
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