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https://www.readbyqxmd.com/read/29789918/recent-experience-and-follow-up-after-surgical-closure-of-secundum-atrial-septal-defect-in-120-children
#1
Geoffroy de Beco, Natasha Mambour, Christophe Vô, Laetitia Vanhoutte, Stéphane Moniotte, Alain Poncelet, Thierry Sluysmans
While percutaneous catheter closure proves an effective treatment for secundum atrial septal defect (ASD2), some child patients require surgical closure. We assessed the risks associated with isolated surgical ASD2 closure by reviewing the outcomes of 120 children operated on between 1999 and 2011 (mean age 4.6 ± 3.9 years, mean weight 17 ± 12 kg). Direct sutures were performed in 4% and patch closures in 96%. The mean cardiopulmonary bypass duration was 38 ± 14 min, aortic cross-clamp time 19 ± 9 min, intensive care unit length of stay 1...
May 22, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29789898/-clinical-parameters-of-patients-with-neovascular-age-related-macular-degeneration-longterm-treatment-results-of-an-outpatient-clinic
#2
S Wassel, E Tsompanidi, E Tahmaz, B Hörster, R Hoerster
BACKGROUND: The clinical outcome of neovascular age-related macular degeneration (nAMD) depends on constant follow-up and consistent treatment. Data about the long-term course of intensive anti-vascular endothelial growth factor (VEGF) therapy from outpatient clinics are rare. OBJECTIVE: The aim of the study was to characterize a population of nAMD patients with long-term follow-up and intensive anti-VEGF therapy. PATIENTS AND METHODS: In a supra-regional outpatient clinic, we retrospectively identified patients who had received at least 30 intravitreal anti-VEGF injections and were followed for at least 4 years...
May 22, 2018: Der Ophthalmologe: Zeitschrift der Deutschen Ophthalmologischen Gesellschaft
https://www.readbyqxmd.com/read/29788037/mycoplasma-pneumoniae-among-children-hospitalized-with-community-acquired-pneumonia
#3
Preeta K Kutty, Seema Jain, Thomas H Taylor, Anna M Bramley, Maureen H Diaz, Krow Ampofo, Sandra R Arnold, Derek J Williams, Kathryn M Edwards, Jonathan A McCullers, Andrew T Pavia, Jonas M Winchell, Stephanie J Schrag, Lauri A Hicks
Background: The burden and epidemiology of Mycoplasma pneumoniae (Mp) among U.S. children (<18 years) hospitalized with community-acquired pneumonia (CAP) are poorly understood. Methods: In the Etiology of Pneumonia in the Community (EPIC) study, we prospectively enrolled 2254 children hospitalized with radiographically-confirmed pneumonia from January 2010-June 2012 and tested nasopharyngeal/oropharyngeal swabs for Mp using real-time polymerase chain reaction (PCR)...
May 17, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29784237/quality-of-life-and-well-being-following-inpatient-and-partial-hospitalization-treatment-for-opioid-use-disorder
#4
Claire E Blevins, Ana M Abrantes, Megan E Kurth, Alan L Gordon, Michael D Stein
Treatment of opioid use disorder often begins with brief intensive inpatient or outpatient programs. Given the high relapse rates following intensive treatment, it is important to determine factors that lead to success post-discharge. Incorporating assessment during and early post-discharge may help determine such factors. The current study evaluated changes in quality of life among individuals during and after discharge from inpatient and partial hospitalization opiate treatment programs. Participants (n = 143) were recruited while in the programs and were re-assessed one month later (n = 113)...
June 2018: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/29781651/exposure-and-cbt-for-chronic-back-pain-an-rct-on-differential-efficacy-and-optimal-length-of-treatment
#5
Julia Anna Glombiewski, Sebastian Holzapfel, Jenny Riecke, Johan W S Vlaeyen, Jeroen de Jong, Gunnar Lemmer, Winfried Rief
OBJECTIVE: Our aim was to establish whether Exposure, a specialized tailored treatment for chronic low back pain, has any advantages over cognitive-behavioral therapy (CBT) among individuals with high fear-avoidance levels. Second, we planned to compare short and long versions of Exposure. Third, we aimed to investigate whether Exposure can be delivered in an outpatient psychological setting. METHOD: A total of 88 Caucasian participants (55% women) were randomized to three different psychological treatment conditions, Exposure-long, Exposure-short, and CBT...
June 2018: Journal of Consulting and Clinical Psychology
https://www.readbyqxmd.com/read/29775603/genetic-and-extracardiac-anomalies-are-associated-with-inferior-single-ventricle-palliation-outcomes
#6
Bahaaldin Alsoufi, Courtney McCracken, Matthew Oster, Subhadra Shashidharan, Kirk Kanter
BACKGROUND: We aim to examine the effect of genetic syndromes and extracardiac anomalies (GS/EC) on single ventricle (SV) palliation with focus on hospital death, interstage mortality, and progression towards subsequent palliation stages. METHODS: 530 neonates with SV underwent first-stage palliation: Norwood (n=284,53%), shunt (n=173,33%), band (n=73,14%). Outcomes were compared between those with GS/EC (n=121,23%) and without GS/EC (n=409,77%). Regression analyses were adjusted for other risk factors (age, gender, prematurity, weight, SV anomaly, first-stage palliation surgery)...
May 15, 2018: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29774394/longitudinal-health-care-cost-in-hypoplastic-left-heart-syndrome-palliation
#7
Jesse E Hansen, Nicolas L Madsen, Laurie Bishop, David L S Morales, Jeffrey B Anderson
Management of hypoplastic left heart syndrome (HLHS) is resource intensive. Heath care systems are pressured to provide value to patients by improving outcomes while decreasing costs. A single-center retrospective cohort of infants with HLHS who underwent Norwood procedure or hybrid Norwood from 2004 to 2014 and survived to first outpatient follow up were studied. The primary outcome was total cost through 12 months with a sub-analysis of patients with 60 months of data. Costs were calculated using internal cost accounting system and reported by cost center...
May 17, 2018: Pediatric Cardiology
https://www.readbyqxmd.com/read/29773712/acute-kidney-injury-and-risk-of-heart-failure-and-atherosclerotic-events
#8
Alan S Go, Chi-Yuan Hsu, Jingrong Yang, Thida C Tan, Sijie Zheng, Juan D Ordonez, Kathleen D Liu
BACKGROUND AND OBJECTIVES: AKI in the hospital is common and is associated with excess mortality. We examined whether AKI is also independently associated with a higher risk of different cardiovascular events in the first year after discharge. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: We conducted a retrospective analysis of a cohort between 2006 and 2013 with follow-up through 2014, within Kaiser Permanente Northern California. We identified all adults admitted to 21 hospitals who had one or more in-hospital serum creatinine test result and survived to discharge...
May 17, 2018: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29773500/an-analysis-on-distribution-and-inter-relationships-of-biomarkers-under-rivaroxaban-in-japanese-patients-with-non-valvular-atrial-fibrillation-cvi-aro-1
#9
Shinya Suzuki, Takeshi Yamashita, Hidefumi Kasai, Takayuki Otsuka, Koichi Sagara
Prothrombin time (PT) has been widely used for measuring anticoagulation intensity under rivaroxaban therapy, but precise information has not been well established yet. Consecutive 96 non-valvular atrial fibrillation (NVAF) under rivaroxaban between Jan/June, 2015 were recruited. Serum concentration (SC) and PT with 5 representative reagents available in Japan (Neoplastin Plus®, Thromborel S®, Thrombocheck PT®, Thrombocheck PT Plus®, and Recombiplastin®) at 2-4 hours after (peak) and before intake of rivaroxaban (trough) were measured at outpatient clinic in the cardiovascular institute (CVI ARO study 1)...
March 15, 2018: Drug Metabolism and Pharmacokinetics
https://www.readbyqxmd.com/read/29771791/a-successful-model-of-expedited-antiretroviral-therapy-for-clinically-stable-patients-living-with-hiv-in-haiti
#10
Colette Guiteau Moise, Vanessa R Rivera, Kelly A Hennessey, Clovy Bellot, Chris Nicholas, Anna P Fang, Rose Irène Verdier, Patrice Severe, Alix Sainvil, Benedict Charles, Derothy Dorval, Juseline St Amour, Jean W Pape, Serena P Koenig
BACKGROUND: Recommendations for universal antiretroviral therapy (ART) have greatly increased the number of HIV-infected patients who qualify for treatment, particularly with early clinical disease. Less intensive models of care are needed for clinically stable patients. SETTING: A Rapid Pathway (RP) model of expedited outpatient care for clinically stable patients was implemented at the Haitian Group for the Study of Kaposi's Sarcoma and Opportunistic Infections (GHESKIO) Center, Port-au-Prince, Haiti...
April 30, 2018: Journal of Acquired Immune Deficiency Syndromes: JAIDS
https://www.readbyqxmd.com/read/29767825/-palliative-sedation-development-and-consensus-of-a-german-language-documentation-template
#11
C Klein, C Wittmann, K N Wendt, C Ostgathe, S Stiel
BACKGROUND: Palliative sedation (PS) serves as a therapeutic option in cases of otherwise intractable suffering. As the use of sedative and hypnotic medication in many diverse situations is a core competency of anesthesiology, anesthesiologists are confronted with questions of sedative therapy at the end of life in institutions for specialized palliative care, in intensive care units and intermediate care wards. In recent years a number of guidelines have been published internationally but so far no official guidelines exist in Germany...
May 16, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29765339/can-model-projects-of-need-adapted-care-reduce-involuntary-hospital-treatment-and-the-use-of-coercive-measures
#12
Alexandre Wullschleger, Jürgen Berg, Felix Bermpohl, Christiane Montag
Intensive outpatient models of need-adapted psychiatric care have been shown to reduce the length of hospital stays and to improve retention in care for people with severe mental illnesses. In contrast, evidence regarding the impact of such models on involuntary hospital treatment and other coercive measures in inpatient settings is still sparse, although these represent important indicators of the patients' wellbeing. In Germany, intensive models of care still have not been routinely implemented, and their effectiveness within the German psychiatric system is only studied in a few pioneering regions...
2018: Frontiers in Psychiatry
https://www.readbyqxmd.com/read/29763267/top-20-research-studies-of-2017-for-primary-care-physicians
#13
Mark H Ebell, Roland Grad
Based on systematic surveillance of more than 110 medical journals, 247 studies met criteria as POEMs (patient-oriented evidence that matters) in 2017. Members of the Canadian Medical Association identified 20 of these POEMs as most relevant to practice. This article reviews the clinical questions and bottom-line answers from these studies. Blood pressure should be measured after a period of rest, using a bare arm, and orthostatic blood pressure is more predictive when measured after one minute of standing rather than three minutes...
May 1, 2018: American Family Physician
https://www.readbyqxmd.com/read/29758575/-descriptive-analysis-of-health-economics-of-intensive-home-care-of-ventilated-patients
#14
Yvonne Lehmann, Julia Ostermann, Thomas Reinhold, Michael Ewers
INTRODUCTION: Long-term ventilated patients in Germany receive intensive care mainly in the patients' home or in assisted-living facilities. There is a lack of knowledge about the nature and extent of resource use and costs associated with care of this small, heterogeneous but overall growing patient group. METHODS: A sub-study in the context of a research project SHAPE analyzed costs of 29 patients descriptively from a social perspective. Direct and indirect costs of intensive home care over a period of three months were recorded and analyzed retrospectively...
May 14, 2018: Das Gesundheitswesen
https://www.readbyqxmd.com/read/29758175/do-different-modes-of-delivering-postoperative-instructions-to-patients-help-reduce-the-side-effects-of-tooth-extraction-a-randomized-clinical-trial
#15
Rasoul Gheisari, Fatemeh Resalati, Sattar Mahmoudi, Ali Golkari, Seyed Ali Mosaddad
PURPOSE: Postoperative instructions that are properly delivered can decrease postextraction side effects, such as stress, anxiety, and pain, in patients undergoing dental extraction. This study examined the role of the mode of delivering postoperative instructions in decreasing the side effects of dental extraction and increasing patient satisfaction after the procedure. MATERIALS AND METHODS: This randomized clinical trial was conducted on a population of 120 patients presenting to the oral and maxillofacial outpatient clinic affiliated with the Shiraz University of Medical Sciences (Shiraz, Iran) in 2015...
April 26, 2018: Journal of Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/29754841/-risks-associated-with-the-use-of-non-steroidal-anti-inflammatory-drugs-during-pneumonia
#16
REVIEW
G Voiriot, M Chalumeau, J Messika, D Basille, B Philippe, J-D Ricard, C Andrejak, V Jounieaux, O Sanchez, M Fartoukh
INTRODUCTION: Outpatient treatment of community-acquired pneumonia (CAP) patients with non-steroidal anti-inflammatory drugs (NSAIDs) is frequent, although this is not based on clinical recommendations and there is no scientific evidence supporting better symptom relief in comparison to acetaminophen. STATE OF THE ART: Experimental data suggest that NSAIDs alter the intrinsic functions of neutrophils, limit their locoregional recruitment, alter bacterial clearance and delay the resolution of inflammatory processes during acute bacterial pulmonary challenge...
May 10, 2018: Revue des Maladies Respiratoires
https://www.readbyqxmd.com/read/29754400/the-international-prevalence-and-variability-of-non-adherence-to-the-non-pharmacologic-treatment-regimen-after-heart-transplantation-findings-from-the-cross-sectional-bright-study
#17
Remon Helmy, Nathalie Duerinckx, Sabina De Geest, Kris Denhaerynck, Lut Berben, Cynthia L Russell, Johan Van Cleemput, Maria G Crespo-Leiro, Fabienne Dobbels
INTRODUCTION: Heart transplant (HTx) recipients need to follow a complex therapeutic regimen. We assessed the international prevalence and variability in non-adherence to six non-pharmacologic treatment components (physical activity, sun protection, diet, alcohol use, non-smoking, and outpatient follow-up visits). METHODS: We used self-report data of 1397 adult HTx recipients from the 36-HTx-center, 11-country, 4-continent, cross-sectional BRIGHT study (ClinicalTrials...
May 13, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/29753159/defining-incidence-and-risk-factors-for-catheter-associated-bloodstream-infections-in-an-outpatient-adult-hematopoietic-cell-transplant-program
#18
Marissa K McDonald, Kathryn A Culos, Katie S Gatwood, Caleb Prow, Heidi Chen, Bipin N Savani, Michael Byrne, Adetola A Kassim, Brian G Engelhardt, Madan Jagasia, Gowri Satyanarayana
BACKGROUND: Allogeneic hematopoietic cell transplant (HCT) patients are at an increased risk of developing central line-associated bloodstream infections (CLABSIs) due to prolonged periods of myelosuppression, immunosuppression, and indwelling catheter days. CLABSIs are among the most serious complications in HCT recipients and can lead to prolonged hospitalizations, intensive care unit (ICU) admissions, lengthy antimicrobial therapies, and increased mortality. There is a lack of data regarding the incidence and risk factors associated with the development of CLABSIs in the HCT population undergoing outpatient transplantation...
May 9, 2018: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/29752345/randomized-outpatient-trial-of-single-and-dual-hormone-closed-loop-systems-that-adapt-to-exercise-using-wearable-sensors
#19
Jessica R Castle, Joseph El Youssef, Leah M Wilson, Ravi Reddy, Navid Resalat, Deborah Branigan, Katrina Ramsey, Joseph Leitschuh, Uma Rajhbeharrysingh, Brian Senf, Samuel M Sugerman, Virginia Gabo, Peter G Jacobs
OBJECTIVE: Automated insulin delivery is the new standard for type 1 diabetes, but exercise-related hypoglycemia remains a challenge. Our aim was to determine whether a dual-hormone closed-loop system using wearable sensors to detect exercise and adjust dosing to reduce exercise-related hypoglycemia would outperform other forms of closed-loop and open-loop therapy. RESEARCH DESIGN AND METHODS: Participants underwent four arms in randomized order: dual-hormone, single-hormone, predictive low glucose suspend, and continuation of current care over 4 outpatient days...
May 11, 2018: Diabetes Care
https://www.readbyqxmd.com/read/29750681/predischarge-and-postdischarge-risk-factors-for-hospital-readmission-among-patients-with-diabetes
#20
Abhijana Karunakaran, Huaqing Zhao, Daniel J Rubin
BACKGROUND: Hospital readmission within 30 days of discharge (30-d readmission) is an undesirable outcome. Readmission of patients with diabetes is common and costly. Most of the studies that have examined readmission risk factors among diabetes patients did not include potentially important clinical data. OBJECTIVES: To provide a more comprehensive understanding of 30-day readmission risk factors among patients with diabetes based on predischarge and postdischarge data...
May 10, 2018: Medical Care
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