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Intensive outpatient

W Weinrebe, S Käbe-Frisch, I Füsgen, M Karaman, E Johannsdottir, S Rupp
OBJECTIVE: To compare the efficacy of desmopressin and placebo in independent geriatric outpatients with nocturnal polyuria (NP). METHODS: A prospective, randomized, single-center, national, double blind, placebo-controlled, fixed-dose, parallel group comparative trial was carried out. The study included 110 geriatric outpatients, 55 patients per treatment group using desmopressin acetate nasal spray (strength: 0.1 mg/ml) once daily of 10 μg/spray blast or placebo...
March 14, 2018: Zeitschrift Für Gerontologie und Geriatrie
Khansoudaphone Phakhounthong, Pimwadee Chaovalit, Podjanee Jittamala, Stuart D Blacksell, Michael J Carter, Paul Turner, Kheng Chheng, Soeung Sona, Varun Kumar, Nicholas P J Day, Lisa J White, Wirichada Pan-Ngum
BACKGROUND: Dengue fever is a re-emerging viral disease commonly occurring in tropical and subtropical areas. The clinical features and abnormal laboratory test results of dengue infection are similar to those of other febrile illnesses; hence, its accurate and timely diagnosis for providing appropriate treatment is difficult. Delayed diagnosis may be associated with inappropriate treatment and higher risk of death. Early and correct diagnosis can help improve case management and optimise the use of resources such as hospital staff, beds, and intensive care equipment...
March 13, 2018: BMC Pediatrics
Ilhan Sag, Ferhat Devrim Zengul, Amy Yarbrough Landry
Many hospitals are competing for survival in their service areas. Because of intense competition within markets, hospitals are developing strategies to differentiate themselves. One way to do so is to create a physical infrastructure and service environment that generate a positive impact on patient perceptions. The purpose of this study is to review the literature on servicescape (i.e., a total impression of a service encounter developed through the use of human senses) and its effects on service quality and patient outcomes in healthcare settings...
March 2018: Journal of Healthcare Management / American College of Healthcare Executives
S Reich-Schupke, E Mohren, M Stücker
BACKGROUND: Implementation of guideline recommendations for the diagnosis and therapy of lipedema and lymphedema seems to be problematic in daily routine. Systematic data for Germany are missing. The aim of the study was data collection regarding diagnosis and therapy of lymphologic diseases in an outpatient setting. METHODS: Monocentric, prospective survey of patients from a lymphologic outpatient clinic using a standardized questionnaire focusing on diagnostics and therapy at the initial diagnosis...
March 12, 2018: Der Hautarzt; Zeitschrift Für Dermatologie, Venerologie, und Verwandte Gebiete
Shigeomi Yokoya, Akihiko Hino, Yukihiro Goto, Youichi Hashimoto, Hideki Oka
BACKGROUND: The headache preceding an intracranial aneurysm (AN) rupture is called a sentinel headache (SH), and it is characterized by a sudden, intense, and persistent headache. As subarachnoid hemorrhage (SAH) often develops within several weeks of SH, its rapid diagnosis and treatment can improve the prognosis. CASE DESCRIPTION: A 52-year-old woman with migraine in her medical history visited the outpatient clinic due to left orbital pain. There was no neurological deficit...
March 9, 2018: World Neurosurgery
Amanda Williams, John Wiggers, Kate M O'Brien, Luke Wolfenden, Sze Lin Yoong, Rebecca K Hodder, Hopin Lee, Emma K Robson, James H McAuley, Robin Haskins, Steven J Kamper, Chris Rissel, Christopher M Williams
We assessed the effectiveness of a 6-month healthy lifestyle intervention, on pain intensity in patients with chronic low back pain who were overweight or obese. We conducted a pragmatic randomised controlled trial (RCT), embedded within a cohort multiple RCT of patients on a waiting list for outpatient orthopaedic consultation at a tertiary hospital in NSW, Australia. Eligible patients with chronic low back pain (>3 months in duration) and BMI ≥27kg/m and <40kg/m were randomly allocated, using a central concealed random allocation process, to receive advice and education and referral to a 6-month telephone-based healthy lifestyle coaching service, or usual care...
March 8, 2018: Pain
Joseph Arthur, Kimberson Tanco, Minjeong Park, Ali Haider, Courtney Maligi, Shalini Dalal, Syed M A Naqvi, Diane Liu, Eduardo Bruera
BACKGROUND: There is currently no universally accepted outcome measure in cancer pain management. The personalized pain goal (PPG) has been shown to be a relevant outcome measure. We examined its use in routine outpatient practice and compared it with the clinical important difference (CID, ≥2 points or 30%), a pain outcome measure frequently used in several clinical studies. METHODS: Initial and follow up clinical information of outpatients with advanced cancer pain were retrospectively reviewed...
March 8, 2018: Journal of Pain and Symptom Management
Volker Gebhardt, Vera Zawierucha, Oliver Schöffski, Anke Schwarz, Christel Weiss, Marc D Schmittner
BACKGROUND: Both general and spinal anaesthesia with short-acting local anaesthetics are suitable and reliable for knee arthroscopy as an ambulatory procedure. Chloroprocaine (CP) 1% seems to be the ideal spinal local anaesthetic for this indication. OBJECTIVE: The aim of this study was to compare spinal anaesthesia using CP 1% with general for outpatient knee arthroscopy with regard to procedure times, occurrence of pain, patient satisfaction and recovery, and also costs...
March 7, 2018: European Journal of Anaesthesiology
Nina Moroz, Robert Sitarz, Andrzej Mruk, Robert Bakalarz, Ewa Maciąg, Jakub Litwiński, Ryszard Wierzbicki
ntroduction: One of the most important goals of preparing a patient for elective gastrointestinal cancer surgery is prevention of postoperative complications. The literature gives many ways to prepare for surgery, but only a few suggests that pre-operative use of rifaximin provides benefits in the form of fewer perioperative complications and reduces the severity of pain during this period. O bjective: The presented project is a retrospective analysis of the effectiveness of rifaximin in the prevention of perioperative complications in patients treated in the Unit of General Surgery with the Orthopedic and Urology in the Hospital of the Ministry of the Interior and Administration in Lublin, and a review of international literature in this subject...
February 28, 2018: Polski Przeglad Chirurgiczny
Hee Sun Kim, Hyun Kyung Kim, Kyung Ok Kang, Yi Sik Kim
AIM: This study aimed to identify health-related quality of life (HRQoL) and its determinants in outpatients with acute coronary syndrome (ACS) after percutaneous coronary intervention. METHODS: A cross-sectional design was used and a total of 124 Korean participants was enrolled. The HRQoL (physical limitations, treatment satisfaction, and disease perception), symptom experience (frequency, severity, and distress), physiological (left ventricular ejection fraction and lipids), psychological (depression and anxiety), and situational (social support) factors were measured, selected on the basis of the theory of unpleasant symptoms...
March 7, 2018: Japan Journal of Nursing Science: JJNS
Leonel J F Estofan, Stanislav Naydin, Gediminas Gliebus
We present a case report of a 20-year-old male with diabetes mellitus type 1, who developed severe painful peripheral neuropathy while on the second of a 10-day course with levofloxacin for the treatment of epididymitis. The intensity of the pain rapidly reached scores of 10/10 in a numeric scale 0/10, and the patient was transferred to an inpatient pain unit where he was treated aggressively with minimal improvement. A skin biopsy revealed small fiber neuropathy. Then the patient was treated with intravenous immunoglobulin, which improved the pain...
January 2018: Journal of Investigative Medicine High Impact Case Reports
Robert D Ashford, Kevin Lynch, Brenda Curtis
BACKGROUND: Substance use disorder research and practice have not yet taken advantage of emerging changes in communication patterns. While internet and social media use is widespread in the general population, little is known about how these mediums are used in substance use disorder treatment. OBJECTIVE: The aims of this paper were to provide data on patients' with substance use disorders mobile phone ownership rates, usage patterns on multiple digital platforms (social media, internet, computer, and mobile apps), and their interest in the use of these platforms to monitor personal recovery...
March 6, 2018: Journal of Medical Internet Research
Matthew Biggerstaff, Michael Johansson, David Alper, Logan C Brooks, Prithwish Chakraborty, David C Farrow, Sangwon Hyun, Sasikiran Kandula, Craig McGowan, Naren Ramakrishnan, Roni Rosenfeld, Jeffrey Shaman, Rob Tibshirani, Ryan J Tibshirani, Alessandro Vespignani, Wan Yang, Qian Zhang, Carrie Reed
Accurate forecasts could enable more informed public health decisions. Since 2013, CDC has worked with external researchers to improve influenza forecasts by coordinating seasonal challenges for the United States and the 10 Health and Human Service Regions. Forecasted targets for the 2014-15 challenge were the onset week, peak week, and peak intensity of the season and the weekly percent of outpatient visits due to influenza-like illness (ILI) 1-4 weeks in advance. We used a logarithmic scoring rule to score the weekly forecasts, averaged the scores over an evaluation period, and then exponentiated the resulting logarithmic score...
February 24, 2018: Epidemics
F Scott Dahlgren, David K Shay, Hector S Izurieta, Richard A Forshee, Michael Wernecke, Yoganand Chillarige, Yun Lu, Jeffrey A Kelman, Carrie Reed
BACKGROUND: Over 34 million residents of the United States aged 65 years old and older are also Medicare prescription drug beneficiaries. Medical claims records for this age group potentially provide a wealth of data for better understanding influenza epidemiology. OBJECTIVE: The purpose of this study was to evaluate data on oseltamivir dispensing extracted from medical claims records as an indicator of influenza activity in the United States for the 2010-11 through 2014-15 influenza seasons...
March 5, 2018: Influenza and Other Respiratory Viruses
Miriam O Ezenwa, Robert E Molokie, Zaijie Jim Wang, Yingwei Yao, Marie L Suarez, Brenda Dyal, Khulud Abudawood, Diana J Wilkie
Patients with sickle cell disease (SCD) report pain scores that appear greater than those reported in a meta-analysis for patients with cancer, but statistical comparisons of the pain scores from both populations have not been published. The goal of the study described here was to compare pain outcomes reported by outpatients with cancer or SCD. Descriptive comparative study. Outpatient oncology or sickle cell clinics. The participants were outpatients (N = 415) from three studies: (1) 106 patients with SCD, 93% African-American (referent group); (2) 140 patients with cancer, 90% Caucasian (race discordant); (3) 169 patients with cancer, 20% Caucasian, 65% African-American (race concordant)...
February 28, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
Panagiotis Krepis, Maria Papasotiriou, Maria N Tsolia, Alexandra Soldatou
OBJECTIVES: This study aimed to assess parental behavior in terms of child restraint systems (CRS) use under emergency conditions while driving to the hospital's outpatient settings as well as their routine child car safety (CCS) practices. METHODS: A cross-sectional survey of parents/caregivers transporting children 13 years or younger was conducted at the Emergency Treatment Center of a pediatric tertiary care center in Athens, Greece. Participants completed a questionnaire inquiring about the possession of CRS, and type and use of appropriate CRS while driving to the Emergency Treatment Center and under routine conditions...
February 28, 2018: Pediatric Emergency Care
Jurgen Cornelis, Ansam Barakat, Jack Dekker, Tessy Schut, Sandra Berk, Hans Nusselder, Nikander Ruhl, Jeroen Zoeteman, Rien Van, Aartjan Beekman, Matthijs Blankers
BACKGROUND: Hospitalization is a common method to intensify care for patients experiencing a psychiatric crisis. A short-term, specialised, out-patient crisis intervention by a Crisis Resolution Team (CRT) in the Netherlands, called Intensive Home Treatment (IHT), is a viable intervention which may help reduce hospital admission days. However, research on the (cost-)effectiveness of alternatives to hospitalisation such as IHT are scarce. In the study presented in this protocol, IHT will be compared to care-as-usual (CAU) in a randomized controlled trial (RCT)...
February 27, 2018: BMC Psychiatry
Daniel Schöttle, Benno G Schimmelmann, Friederike Ruppelt, Alexandra Bussopulos, Marietta Frieling, Evangelia Nika, Luise Antonia Nawara, Dietmar Golks, Andrea Kerstan, Matthias Lange, Michael Schödlbauer, Anne Daubmann, Karl Wegscheider, Anja Rohenkohl, Gizem Sarikaya, Mary Sengutta, Daniel Luedecke, Linus Wittmann, Gunda Ohm, Christina Meigel-Schleiff, Jürgen Gallinat, Klaus Wiedemann, Thomas Bock, Anne Karow, Martin Lambert
The ACCESS-model offers integrated care including assertive community treatment to patients with psychotic disorders. ACCESS proved more effective compared to standard care (ACCESS-I study) and was successfully implemented into clinical routine (ACCESS-II study). In this article, we report the 4-year outcomes of the ACCESS-II study. Between May 2007 and December 2013, 115 patients received continuous ACCESS-care. We hypothesized that the low 2-year disengagement and hospitalization rates and significant improvements in psychopathology, functioning, and quality of life could be sustained over 4 years...
2018: PloS One
Baxter B Allen, Peter B Forgacs, Malik A Fakhar, Xian Wu, Linda M Gerber, Srikanth Boddu, Santosh B Murthy, Philip E Stieg, Halinder S Mangat
BACKGROUND: Data on new-onset seizures after treatment of aneurysmal subarachnoid hemorrhage (aSAH) patients are limited and variable. We examined the association between new-onset seizures after aSAH and aneurysm treatment modality, as well their relationship with initial clinical severity of aSAH and outcomes. METHODS: This is a retrospective cohort study of all aSAH patients admitted to our institution over a 6-year period. 'Seizures' were defined as any observed clinical seizure or electrographic seizure on continuous electroencephalogram (cEEG) recordings, as determined by the reviewing neurophysiologist...
February 26, 2018: Neurocritical Care
R A Briggs, J R Houck, P C LaStayo, J M Fritz, M J Drummond, R L Marcus
OBJECTIVES: Post rehabilitation, older adults with hip fracture display low vertical ground reaction force (vGRF) on the involved lower extremity during a sit-to-stand task and low physical function. The purpose of this study was to test whether muscle performance, involved side vGRF during a sit-to-stand task, and physical function improved following multimodal high-intensity resistance training, when initiated after usual care (2 to 6 months after hip fracture). DESIGN: Case series study, 12 weeks extended high-intensity strength training intervention following hip fracture...
2018: Journal of Nutrition, Health & Aging
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