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https://www.readbyqxmd.com/read/28447107/-role-of-anesthesiology-in-pain-medicine-and-palliative-care-treatment-in-german-hospitals-survey-of-department-heads-of-anesthesiology-on-treatment-structures
#1
J Erlenwein, F Petzke, U Stamer, W Meißner, F Nauck, E Pogatzki-Zahn, W Koppert, C Maier
BACKGROUND: The aim of this analysis was to describe the role of anesthesiology departments in pain medicine and palliative care services in German hospitals. METHOD: In the year 2012, all heads of departments of anesthesiology registered with the German Society of Anesthesiology and Intensive Care Medicine were surveyed about structures of pain medicine and palliative care services in their hospitals using a standardized postal questionnaire. RESULTS: Out of 408 returned questionnaires (response rate 47%) 403 could be evaluated...
April 26, 2017: Der Anaesthesist
https://www.readbyqxmd.com/read/28442516/in-vitro-study-of-the-thrombogenic-activity-of-platelet-derived-microparticles-from-patients-with-acute-coronary-syndrome
#2
Muyesai Nijiati, Abulijiang Saidaming, Li Guoqing
BACKGROUND: To observe the thrombogenic activity of platelet-derived microparticles (PMPs) in PMP-free plasma from non-coronary artery disease (non-CAD) patients and explore the relationship between PMPs and thrombosis in acute coronary syndrome (ACS) patients. METHODS: Patients with ACS who were diagnosed at the outpatient department of cardiology in the People's Hospital of Xinjiang Uygur Autonomous Region, and non-CAD subjects were enrolled in the study from January 2011 to December 2014...
March 2017: Annals of Clinical and Laboratory Science
https://www.readbyqxmd.com/read/28437372/heart-rate-modification-of-cardiac-output-following-cardiac-surgery-the-importance-of-cardiac-time-intervals
#3
Guido Tavazzi, Andy Kontogeorgis, Fabio Guarracino, Niels Bergsland, Ana Martinez-Naharro, John Pepper, Susanna Price
OBJECTIVES: Inadequate cardiac output is associated with a poor outcome following cardiac surgery and is generally modified by the use of positive inotropic agents, volume resuscitation, and pacing. Echocardiography-guided pacemaker optimization is used in the outpatient setting, using different variables including total isovolumic time and the Tei index. We sought to determine the acute impact of heart rate on cardiac electromechanics, cardiac output, and stroke volume in the perioperative setting...
April 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28434533/performance-of-fixed-heart-rate-increment-targets-of-20-vs-30-beats-per-minute-for-exercise-rehabilitation-prescription-in-outpatients-with-heart-failure
#4
Jennifer L Reed, Angelica Z Blais, Marja-Leena Keast, Andrew L Pipe, Robert D Reid
BACKGROUND: Patients with heart failure (HF) should exercise at 40%-60% heart rate reserve (HRR) during the first 3 weeks of an outpatient cardiac rehabilitation (CR) program and at 50%-80% HRR thereafter. Arbitrary methods to prescribe exercise intensity such as resting HR (RHR) plus 20 or 30 beats per minute (bpm) (RHR + 20 or RHR + 30) are recommended for inpatients after a myocardial infarction or those recovering from heart surgery. This approach has been repurposed by outpatient CR programs to prescribe exercise intensity for patients with HF, yet its efficacy has not been evaluated...
February 2, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28432040/usability-acceptability-and-adherence-to-an-electronic-self-monitoring-system-in-patients-with-major-depression-discharged-from-inpatient-wards
#5
Lise Lauritsen, Louise Andersen, Emilia Olsson, Stine Rauff Søndergaard, Lasse Benn Nørregaard, Philip Kaare Løventoft, Signe Dunker Svendsen, Erik Frøkjær, Hans Mørch Jensen, Ida Hageman, Lars Vedel Kessing, Klaus Martiny
BACKGROUND: Patients suffering from depression have a high risk of relapse and readmission in the weeks following discharge from inpatient wards. Electronic self-monitoring systems that offer patient-communication features are now available to offer daily support to patients, but the usability, acceptability, and adherence to these systems has only been sparsely investigated. OBJECTIVE: We aim to test the usability, acceptability, adherence, and clinical outcome of a newly developed computer-based electronic self-assessment system (the Daybuilder system) in patients suffering from depression, in the period from discharge until commencing outpatient treatment in the Intensive Outpatient Unit for Affective Disorders...
April 21, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28430557/utilization-management-of-high-cost-imaging-in-an-outpatient-setting-in-a-large-stable-patient-and-provider-cohort-over-7-years
#6
Jeffrey B Weilburg, Christopher L Sistrom, Daniel I Rosenthal, Markus B Stout, Keith J Dreyer, Helaine R Rockett, Jason M Baron, Timothy G Ferris, James H Thrall
Purpose To quantify the effect of a comprehensive, long-term, provider-led utilization management (UM) program on high-cost imaging (computed tomography, magnetic resonance imaging, nuclear imaging, and positron emission tomography) performed on an outpatient basis. Materials and Methods This retrospective, 7-year cohort study included all patients regularly seen by primary care physicians (PCPs) at an urban academic medical center. The main outcome was the number of outpatient high-cost imaging examinations per patient per year ordered by the patient's PCP or by any specialist...
April 21, 2017: Radiology
https://www.readbyqxmd.com/read/28430046/an-outpatient-methadone-weaning-program-by-a-neonatal-intensive-care-unit-for-neonatal-abstinence-syndrome
#7
Andrew Lai, Patrick Philpot, Jenny Boucher, Andrew Meyer
Through retrospective chart review, this study described characteristics and length of stay for a cohort of newborns discharged on methadone following an inpatient weaning for neonatal abstinence syndrome (NAS). Data were assessed for all term infants born between January 1, 2010, and December 31, 2014, admitted to the hospital with a co-diagnosis of NAS at discharge, for gestational age, length of stay, days on treatment protocol before discharge, time to once-daily interval methadone dosing, and hospital charges, as well as for categorical characteristics...
April 21, 2017: Population Health Management
https://www.readbyqxmd.com/read/28429611/consensus-statement-on-inpatient-use-of-continuous-glucose-monitoring
#8
Amisha Wallia, Guillermo E Umpierrez, Robert J Rushakoff, David C Klonoff, Daniel J Rubin, Sherita Hill Golden, Curtiss B Cook, Bithika Thompson
In June 2016, Diabetes Technology Society convened a panel of US experts in inpatient diabetes management to discuss the current and potential role of continuous glucose monitoring (CGM) in the hospital. This discussion combined with a literature review was a follow-up to a meeting, which took place in May 2015. The panel reviewed evidence on use of CGM in 3 potential inpatient scenarios: (1) the intensive care unit (ICU), (2) non-ICU, and (3) transitioning outpatient CGM use into the hospital setting. Panel members agreed that data from limited studies and theoretical considerations suggested that use of CGM in the hospital had the potential to improve patient clinical outcomes, and in particular reduction of hypoglycemia...
April 1, 2017: Journal of Diabetes Science and Technology
https://www.readbyqxmd.com/read/28427868/potential-palliative-care-quality-indicators-in-heart-disease-patients-a-review-of-the-literature
#9
REVIEW
Atsushi Mizuno, Mitsunori Miyashita, Akitoshi Hayashi, Fujimi Kawai, Koichiro Niwa, Akemi Utsunomiya, Shun Kohsaka, Takashi Kohno, Takeshi Yamamoto, Morimasa Takayama, Toshihisa Anzai
In spite of the increasing interest in palliative care for heart disease, data on the detailed methods of palliative care and its efficacy specifically in heart disease are still lacking. A structured PubMed literature review revealed no quality indicators of palliative care in heart disease. Therefore, we performed a narrative overview of the potential quality indicators in heart disease by reviewing previous literature concerning quality indicators in cancer patients. We summarize seven potential categories of quality indicators in heart disease: (1) presence and availability of a palliative care unit, palliative care team, and outpatient palliative care; (2) human resources such as number of skilled staff; (3) infrastructure; (4) presence and frequency of documentation or family survey; (5) patient-reported outcome measure (PROM) data and disease-specific patient quality of life such as The Kansas City Cardiomyopathy Questionnaire (KCCQ); (6) questionnaires and interviews about the quality of palliative care after death, including bereaved family surveys; and (7) admission-related outcomes such as place of death and intensive care unit length of stay...
April 17, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28426362/predicting-change-in-an-integrated-dual-diagnosis-substance-abuse-intensive-outpatient-program
#10
Edward A Wise, David L Streiner, Robert J Gallop
Research on routine outcome monitoring in psychotherapy settings is plentiful but not without implementation obstacles. In fact, there is a relative dearth of real-time outcome monitoring in substance use treatment settings. Numerous barriers to the development and implementation of clinical decision support tools and outcome monitoring of substance use patients, including the need to establish expected trajectories of change and use of reliable change indices have been identified (Goodman, McKay, & DePhilippis, 2013 )...
June 7, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28423147/adherence-to-high-intensity-statins-following-a-myocardial-infarction-hospitalization-among-medicare-beneficiaries
#11
Lisandro D Colantonio, Lei Huang, Keri L Monda, Vera Bittner, Maria-Corina Serban, Benjamin Taylor, Todd M Brown, Stephen P Glasser, Paul Muntner, Robert S Rosenson
Importance: High-intensity statins are recommended following myocardial infarction. However, patients may not continue taking this medication with high adherence. Objective: To estimate the proportion of patients filling high-intensity statin prescriptions following myocardial infarction who continue taking this medication with high adherence and to analyze factors associated with continuing a high-intensity statin with high adherence after myocardial infarction...
April 19, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28413268/novel-propofol-derivatives-and-implications-for-anesthesia-practice
#12
REVIEW
Aiden Y Feng, Alan D Kaye, Rachel J Kaye, Kumar Belani, Richard D Urman
Propofol (2,6-diisopropylphenol) is the most commonly used intravenous agent for induction of anesthesia. It is also used for maintenance of anesthesia and sedation in both Intensive Care Units and outpatient procedural settings. Its success in the clinical setting has been a result of its rapid onset, short duration of action, and minimal side effects despite disadvantages associated with its oil emulsion formulation. Early attempts to alter the standard emulsion or to develop new formulations with cyclodextrins and micelles to resolve issues with pain upon injection, the need for antimicrobial agents, and possible hyperlipidemia have mostly failed...
January 2017: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28412900/reducing-behavioral-health-inpatient-readmissions-for-people-with-substance-use-disorders-do-follow-up-services-matter
#13
Sharon Reif, Andrea Acevedo, Deborah W Garnick, Catherine A Fullerton
OBJECTIVE: Individuals with substance use disorders are at high risk of hospital readmission. This study examined whether follow-up services received within 14 days of discharge from an inpatient hospital stay or residential detoxification reduced 90-day readmissions among Medicaid enrollees whose index admission included a substance use disorder diagnosis. METHODS: Claims data were analyzed for Medicaid enrollees ages 18-64 with a substance use disorder diagnosis coded in any position for an inpatient hospital stay or residential detoxification in 2008 (N=30,439)...
April 17, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28409699/potential-for-medicaid-savings-a-state-and-national-comparison-of-an-innovative-neonatal-abstinence-syndrome-treatment-model
#14
Lori Dickes, Julie Summey, Rachel Mayo, Jennifer Hudson, Windsor Westbrook Sherrill, Liwei Chen
In recent years, neonatal abstinence syndrome (NAS) rates have increased rapidly across the United States, rising from 1.2 (2000) to 5.8 (2012) per 1000 hospital births annually. Because most NAS infants are treated in an intensive care setting, associated hospital charges are high and continue to escalate, rising on average from $39,400 in 2000 to $66,700 in 2012. An innovative NAS treatment program, which includes early-initiated methadone therapy, rooming-in, and combined inpatient/outpatient weaning in a low-acuity nursery, has been in place since 2003 at a large Southeastern hospital...
April 14, 2017: Population Health Management
https://www.readbyqxmd.com/read/28409056/establishing-seasonal-and-alert-influenza-thresholds-in-cambodia-using-the-who-method-implications-for-effective-utilization-of-influenza-surveillance-in-the-tropics-and-subtropics
#15
Sovann Ly, Takeshi Arashiro, Vanra Ieng, Reiko Tsuyuoka, Amy Parry, Paul Horwood, Seng Heng, Sarah Hamid, Katelijn Vandemaele, Savuth Chin, Borann Sar, Yuzo Arima
OBJECTIVE: To establish seasonal and alert thresholds and transmission intensity categories for influenza to provide timely triggers for preventive measures or upscaling control measures in Cambodia. METHODS: Using Cambodia's influenza-like illness (ILI) and laboratory-confirmed influenza surveillance data from 2009 to 2015, three parameters were assessed to monitor influenza activity: the proportion of ILI patients among all outpatients, proportion of ILI samples positive for influenza and the product of the two...
January 2017: Western Pacific Surveillance and Response Journal: WPSAR
https://www.readbyqxmd.com/read/28398566/twelve-month-health-care-use-and-mortality-in-commercially-insured-young-people-with-incident-psychosis-in-the-united-states
#16
Michael Schoenbaum, Jason M Sutherland, Andre Chappel, Susan Azrin, Amy B Goldstein, Agnes Rupp, Robert K Heinssen
OBJECTIVE: To assess 12-month mortality and patterns of outpatient and inpatient treatment among young people experiencing an incident episode of psychosis in the United States. METHOD: Prospective observational analysis of a population-based cohort of commercially insured individuals aged 16-30 receiving a first observed (index) diagnosis of psychosis in 2008-2009. Data come from the US Department of Health and Human Services' Multi-Payer Claims Database Pilot...
April 7, 2017: Schizophrenia Bulletin
https://www.readbyqxmd.com/read/28386785/assessing-the-prognostic-features-of-a-pain-classification-system-in-advanced-cancer-patients
#17
Joseph Arthur, Kimberson Tanco, Ali Haider, Courtney Maligi, Minjeong Park, Diane Liu, Eduardo Bruera
PURPOSE: The Edmonton Classification System for Cancer Pain (ECS-CP) has been shown to predict pain management complexity based on five features: pain mechanism, incident pain, psychological distress, addictive behavior, and cognitive function. The main objective of our study was to explore the association between ECS-CP features and pain treatment outcomes among outpatients managed by a palliative care specialist-led interdisciplinary team. METHODS: Initial and follow-up clinical information of 386 eligible supportive care outpatients were retrospectively reviewed and analyzed...
April 6, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28379861/extended-release-injectable-naltrexone-xr-ntx-with-intensive-psychosocial-therapy-for-amphetamine-dependent-persons-seeking-treatment-a-placebo-controlled-trial
#18
Valgerdur Runarsdottir, Ingunn Hansdottir, Thorarinn Tyrfingsson, Magnus Einarsson, Karen Dugosh, Charlotte Royer-Malvestuto, Helen Pettinati, Jag Khalsa, George E Woody
OBJECTIVE: Explore the efficacy of extended-release injectable naltrexone (XR-NTX) for preventing relapse to amphetamine use. METHOD: Clinical trial of 100 amphetamine-dependent, treatment-seeking patients who were randomized to 6 monthly 380 mg doses of XR-NTX or matching placebo before entering intensive outpatient after varying lengths of inpatient treatment in Reykjavik, Iceland. Weekly urine drug tests, retention, and standardized instruments assessed efficacy...
April 4, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28378968/patient-aggression-towards-different-professional-groups-of-healthcare-workers
#19
Krystyna Kowalczuk, Elżbieta Krajewska-Kułak
INTRODUCTION: Patient aggression affects healthcare quality and, in extreme situations, may even lead to medical malpractice. Little is known, however, about the specific distribution of health care professionals' exposure to patient aggression in various countries. OBJECTIVE: The aim of this study was to assess the exposure of various professional groups of healthcare personnel to patient aggression, and to identify potential determinants (medical profession, age, gender, professional experience and employment at outpatient/inpatient healthcare units) of this exposure...
March 31, 2017: Annals of Agricultural and Environmental Medicine: AAEM
https://www.readbyqxmd.com/read/28378080/cost-analysis-of-leak-after-sleeve-gastrectomy
#20
Marius Nedelcu, Thierry Manos, Michel Gagner, Imane Eddbali, Ahmed Ahmed, Patrick Noel
BACKGROUND: Leaks after laparoscopic sleeve gastrectomy (LSG) are serious complications of this procedure. The objective of the present study was to evaluate the costs of leaks after LSG. SETTING: Private hospital, France. METHODS: A retrospective analysis was conducted on a prospective cohort of 2012 cases of LSG between September 2005 and December 2014. Data were collected on all diagnostic and therapeutic measures necessary to manage leaks, ward, and intensive care unit (ICU) length of stay...
April 4, 2017: Surgical Endoscopy
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