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Post-discharge interventions

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https://www.readbyqxmd.com/read/28644212/worsening-atrioventricular-conduction-after-hospital-discharge-in-patients-with-st-segment-elevation-myocardial-infarction-undergoing-primary-percutaneous-coronary-intervention-the-horizons-ami-trial
#1
Ioanna Kosmidou, Björn Redfors, Thomas McAndrew, Monica Embacher, Roxana Mehran, José M Dizon, Ori Ben-Yehuda, Gary S Mintz, Gregg W Stone
BACKGROUND: The chronic effects of ST-segment elevation myocardial infarction (STEMI) on the atrioventricular conduction (AVC) system have not been elucidated. This study aimed to evaluate the incidence, predictors, and outcomes of worsened AVC post-STEMI in patients treated with a primary percutaneous coronary intervention (PCI). PATIENTS AND METHODS: The current analysis included patients from the HORIZONS-AMI trial who underwent primary PCI and had available ECGs...
June 21, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28643570/home-based-neurologic-music-therapy-for-arm-hemiparesis-following-stroke-results-from-a-pilot-feasibility-randomized-controlled-trial
#2
Alexander J Street, Wendy L Magee, Andrew Bateman, Michael Parker, Helen Odell-Miller, Jorg Fachner
OBJECTIVE: To assess the feasibility of a randomized controlled trial to evaluate music therapy as a home-based intervention for arm hemiparesis in stroke. DESIGN: A pilot feasibility randomized controlled trial, with cross-over design. Randomization by statistician using computer-generated, random numbers concealed in opaque envelopes. SETTING: Participants' homes across Cambridgeshire, UK. SUBJECTS: Eleven people with stroke and arm hemiparesis, 3-60 months post stroke, following discharge from community rehabilitation...
June 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28641999/effect-of-pharmacist-care-on-medication-adherence-and-cardiovascular-outcomes-among-patients-post-acute-coronary-syndrome-a%C3%A2-systematic-review
#3
REVIEW
Maguy Saffouh El Hajj, Myriam Jihad Jaam, Ahmed Awaisu
BACKGROUND: The impact of collaborative and multidisciplinary health care on the outcomes of care in patients with acute coronary syndromes (ACS) is well-established in the literature. However, there is lack of high quality evidence on the role of pharmacist care in this setting. OBJECTIVE: This systematic review aimed to evaluate the impact of pharmacist care on patient outcomes (readmission, mortality, emergency visits, and medication adherence) in patients with ACS at or post-discharge...
June 13, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28639340/impact-of-frailty-and-residual-subsyndromal-delirium-on-1-year-functional-recovery-a-prospective-cohort-study
#4
Justin Chew, Wee Shiong Lim, Mei Sian Chong, Yew Yoong Ding, Laura Tay
AIM: To investigate the association between frailty and incomplete delirium recovery at discharge (residual subsyndromal delirium [RSSD]), and to examine the mediating role of RSSD in the relationship between frailty and functional recovery at 12 months post-delirium. METHODS: This was a prospective observational study of 234 individuals aged ≥65 years admitted to a specialized delirium unit. A 20-item frailty index was derived using items from a comprehensive geriatric assessment...
June 22, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28639117/tubeless-outpatient-robotic-upper-urinary-tract-reconstruction-in-the-pediatric-population-short-term-assessment-of-safety
#5
Eric J Fichtenbaum, Andrew C Strine, Charles W Concodora, Marion Schulte, Paul H Noh
Robotic upper urinary tract reconstruction (UUTR) has been widely utilized for surgical management of congenital obstruction. To further reduce morbidity and simplify postoperative care, outpatient robotic pyeloplasty (RP) and robotic ureteroureterostomy (RUU) were performed without ureteral stents, drains, or urethral catheters. The aim of the study was to assess the safety of performing tubeless robotic UUTR as an outpatient procedure. A retrospective review was performed for patients who underwent outpatient tubeless RP and RUU between July 2015 and January 2017...
June 21, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28638566/necessity-is-the-mother-of-invention-an-innovative-hospitalist-resident-initiative-for-improving-quality-and-reducing-readmissions-from-skilled-nursing-facilities
#6
Sunny Petigara, Mahesh Krishnamurthy, David Livert
Background: Hospital readmissions have been a major challenge to the US health system. Medicare data shows that approximately 25% of Medicare skilled nursing facility (SNF) residents are readmitted back to the hospital within 30 days. Some of the major reasons for high readmission rates include fragmented information exchange during transitions of care and limited access to physicians round-the-clock in SNFs. These represent safety, quality, and health outcome concerns. Aim: The goal of the project was to reduce hospital readmission rates from SNFs by improving transition of care and increasing physician availability in SNFs (five to seven days a week physical presence with 24/7 accessibility by phone)...
March 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28637773/follow-up-of-a-randomized-trial-on-postdischarge-nutrition-in-preterm-born-children-at-age-8-y
#7
Charlotte A Ruys, Monique van de Lagemaat, Martijn Jj Finken, Harrie N Lafeber
Background: Early nutritional interventions may modulate health risks in preterm-born infants. Previously, we showed that preterm-born infants fed an isocaloric protein- and mineral-enriched postdischarge formula (PDF) from term age to 6-mo corrected age (CA) gained more lean mass than did those fed term formula (TF). Long-term follow-up of randomized nutritional trials is important to test the hypothesis that short-term positive effects on health are sustainable.Objective: The aim of this follow-up study was to compare body size, body composition, and metabolic health at age 8 y in preterm-born children who were randomly assigned to receive either PDF or TF from term age until 6-mo CA...
June 21, 2017: American Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28635194/volitional-rehabilitative-assessments-in-patients-admitted-in-a-post-intensive-care-step-down-unit-a-feasibility-study
#8
Mara Paneroni, Francesco D' Abrosca, Georges Fokom, Laura Comini, Michele Vitacca
A high variability in functional tests and activities used during the pulmonary rehabilitation has been observed in post-intensive care unit (ICU) patients, and the best battery of tests to adopt has not been described yet. We tested in patients admitted in a post-ICU Step Down Unit the ability to perform the more frequent functional volitional tests. The relations of each single volitional test with general disability and dyspnea at discharge were also evaluated. Ten volitional tests including: bedside spirometry test (ST: FEV1%, FVC%), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), Peak Expiratory Flow during Cough (PCEF), Quadriceps Muscle Strength (QMS), latissimus Dorsi and teres Major Strength (DMS), Brachial biceps Muscle Strength (BMS), effort tolerance measured by sit-to-stand test, Takahashi test and 6-Min Walking Test (6MWT), were evaluated in post-ICU patients at entry and discharge from in-hospital rehabilitation...
May 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28629763/delayed-referral-to-specialist-centre-increases-morbidity-in-patients-with-bile-duct-injury-bdi-after-laparoscopic-cholecystectomy-lc
#9
S Martinez-Lopez, V Upasani, S Pandanaboyana, M Attia, G Toogood, P Lodge, E Hidalgo
BACKGROUND: There is still a debate regarding the optimal management of bile duct injury following cholecystectomy. Our aim was to ascertain if delayed referral influenced clinical outcomes for patients with BDI treated in our institution. MATERIALS AND METHODS: We interrogated a prospectively maintained database, including all patients with BDI (Bismuth and Strasberg classifications) post LC managed in our unit from 2000-2014. Referrals were arbitrarily defined as early (<96 hours from the injury) and delayed (>96 hours)...
June 16, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28625445/prospective-double-blind-randomized-placebo-controlled-clinical-trial-of-the-pectoral-nerves-pecs-block-type-ii
#10
Barbara Versyck, Geert-Jan van Geffen, Patrick Van Houwe
STUDY OBJECTIVE: The aim of this clinical trial was to test the hypothesis whether adding the pectoral nerves (Pecs) block type II to the anesthetic procedure reduces opioid consumption during and after breast surgery. DESIGN: A prospective randomized double blind placebo-controlled study. SETTING: A secondary hospital. PATIENTS: 140 breast cancer stage 1-3 patients undergoing mastectomy or tumorectomy with sentinel node or axillary node dissection...
August 2017: Journal of Clinical Anesthesia
https://www.readbyqxmd.com/read/28618192/the-patient-buddy-app-can-potentially-prevent-hepatic-encephalopathy-related-readmissions
#11
Dinesh Ganapathy, Chathur Acharya, Jatinder Lachar, Kavish Patidar, Richard K Sterling, Melanie B White, Catherine Ignudo, Swamy Bommidi, John DeSoto, Leroy R Thacker, Scott Matherly, Jawaid Shaw, Mohammad S Siddiqui, Puneet Puri, Arun J Sanyal, Velimir Luketic, Hannah Lee, R Todd Stravitz, Jasmohan S Bajaj
BACKGROUND AND AIM: Readmissions are a major burden in cirrhosis. A proportion of readmissions in cirrhosis, especially due to hepatic encephalopathy (HE) could be avoided through patient and caregiver engagement. We aimed to define the feasibility of using the Patient Buddy App and its impact on 30-day readmissions by engaging and educating cirrhotic inpatients and caregivers in a pilot study. METHODS: Cirrhotic inpatients with caregivers were enrolled and followed for 30 days post-discharge...
June 15, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28609813/trajectories-of-self-care-agency-and-associated-factors-in-lung-transplant-recipients-over-the-first-12-months-following-transplantation
#12
L Hu, J H Lingler, A DeVito Dabbs, M A Dew, S M Sereika
Self-care agency (SCA), defined as one's ability and willingness to engage in self-care behaviors, can influence actual performance of self-care behaviors in lung transplant recipients (LTRs). Understanding patterns of SCA over time may inform the design of interventions to promote self-care in LTRs. Using group-based trajectory modeling, we sought to identify patterns and correlates of SCA among 94 LTRs over the first 12-months post-transplant. Baseline measures of sociodemographic, clinical, and psychosocial factors, and longitudinally assessed psychological distress were examined for their associations with predicted trajectory group membership...
June 13, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28606660/the-addition-of-endovascular-intervention-for-dural-venous-sinus-thrombosis-single-center-experience-and-review-of-literature
#13
Eric M Nyberg, David Case, Lidia M Nagae, Justin M Honce, William Reyenga, Joshua Seinfeld, Sharon Poisson, Michelle H Leppert
BACKGROUND: Dural venous sinus thrombosis (DVST) is a cause of infarction and intracranial hemorrhage (ICH) that can lead to significant morbidity. Endovascular therapy has emerged as an adjunctive therapy in select cases but has been associated with increased hemorrhagic complications. We present our experience with a large single-center cohort of DVST cases treated with current-generation thrombectomy devices. MATERIALS AND METHODS: In this retrospective cohort study, a chart review was performed to compare presentations and outcomes of patients treated with anticoagulation alone with those treated with additional interventional therapy, using the modified Rankin Scale (mRS) score at discharge and at 90 days' follow-up...
June 9, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28595694/myocardial-damage-in-patients-with-deferred-stenting-after-stemi-a-danami-3-defer-substudy
#14
Jacob Lønborg, Thomas Engstrøm, Kiril Aleksov Ahtarovski, Lars Nepper-Christensen, Steffen Helqvist, Niels Vejlstrup, Kasper Kyhl, Mikkel Malby Schoos, Ali Ghotbi, Christoffer Göransson, Litten Bertelsen, Lene Holmvang, Frants Pedersen, Erik Jørgensen, Kari Saunamäki, Peter Clemmensen, Ole De Backer, Lene Kløvgaard, Dan Eik Høfsten, Lars Køber, Henning Kelbæk
BACKGROUND: Although some studies found improved coronary flow and myocardial salvage when stent implantation was deferred, the DANAMI-3-DEFER (Third DANish Study of Optimal Acute Treatment of Patients With ST-elevation Myocardial Infarction) did not show any improvement in clinical outcome in patients with ST-segment elevation myocardial infarction (STEMI) treated with primary percutaneous coronary intervention (PCI) and deferred stenting. OBJECTIVES: This study sought to evaluate the effect of deferred stent implantation on infarct size, myocardial salvage, and microvascular obstruction (MVO) in patients with STEMI...
June 13, 2017: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/28595219/-hybrid-coronary-revascularization-of-minimally-invasive-coronary-artery-bypass-grafting-and-percutaneous-coronary-intervention-in-a-patient-with-left-main-coronary-stenosis
#15
Yujiro Kawai, Hirokazu Niitsu, Takashi Yanagisawa, Masayuki Ogihara, Gentaku Hama, Yasuyuki Toyoda, Hikaru Kimura, Miki Horigome, Yasutoshi Tsuda, Yoshikazu Yazaki, Takahiro Takemura
We report a successful case of hybrid coronary revascularization of minimally invasive coronary artery bypass grafting( MICS-CABG) and percutaneous coronary intervention(PCI). The patient was a 78-year-old man with angina pectoris due to left main trunk (LMT) lesion, and had a history of repeated PCI to the left anterior descending artery (LAD) and the left circumflex artery (LCX) for angina pectoris. He presented with a chest pain on effort in June, 2015. A coronary angiogram showed a severe stenosis in the LMT extending to LAD and LCX...
June 2017: Kyobu Geka. the Japanese Journal of Thoracic Surgery
https://www.readbyqxmd.com/read/28593708/age-80-years-and-over-is-not-associated-with-increased-morbidity-and-mortality-following-pancreaticoduodenectomy
#16
Sandy Y Kim, Michael A Fink, Marcos Perini, Nezor Houli, Laurence Weinberg, Vijayaragavan Muralidharan, Graham Starkey, Robert M Jones, Christopher Christophi, Mehrdad Nikfarjam
BACKGROUND: Pancreaticoduodenectomy (PD) is associated with high morbidity, which is perceived to be increased in the elderly. To our knowledge there have been no Australian series that have compared outcomes of patients over the age of 80 undergoing PD to those who are younger. METHODS: Patients who underwent PD between January 2008 and November 2015 were identified from a prospectively maintained database. RESULTS: A total of 165 patients underwent PD of whom 17 (10...
June 7, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28591764/a-randomized-controlled-pilot-trial-of-interventions-to-improve-functional-recovery-after-hospitalization-in-older-adults-feasibility-and-adherence
#17
Rachel R Deer, Shawn M Goodlett, Steve R Fisher, Jacques Baillargeon, Jared M Dickinson, Mukaila Raji, Elena Volpi
Background.: Hospitalization is a major risk factor for functional decline, disability, loss of independence, and mortality in older adults. Evidence-based interventions to improve functional recovery from hospitalization are difficult to evaluate and implement in geriatric patients. The goal of this pilot study was to test the feasibility of recruiting geriatric inpatients and implementing pragmatic interventions to improve physical function following hospitalization. Methods...
June 7, 2017: Journals of Gerontology. Series A, Biological Sciences and Medical Sciences
https://www.readbyqxmd.com/read/28585669/effectiveness-of-traumatic-brain-injury-management-guideline-introduction-in-hungary
#18
Abayomi Sorinola, Andras Buki, Janos Sandor, Endre Czeiter
AIM: The aim of this study was to describe the impact of the Traumatic Brain Injury management guideline introduction in Hungary. MATERIAL AND METHODS: Hospital discharge records (HDR) including age, gender, codes of interventions applied, ICD codes of diagnosed disorders of patients admitted between 01/01/2004 and 31/12/2010 with diagnosis of intracranial injury (S06 by ICD10) from every inpatient institution in Hungary were collected from the database of National Health Insurance Fund (NHIF)...
April 27, 2017: Turkish Neurosurgery
https://www.readbyqxmd.com/read/28583211/parenting-a-child-at-home-with-hypoplastic-left-heart-syndrome-experiences-of-commitment-of-stress-and-of-love
#19
Annie M Cantwell-Bartl, James Tibballs
OBJECTIVE: To evaluate the experiences of parenting a child with hypoplastic left heart syndrome after the child has been discharged home from hospital. DESIGN: A study of the parents' experiences using face-to-face interviews and psychometric measures with parents whose child had survived stage surgery. SETTING: Parents were interviewed within the home environment or within the hospital if that was their choice. SUBJECTS: A total of 29 parents (16 mothers and 13 fathers) of surviving children...
June 6, 2017: Cardiology in the Young
https://www.readbyqxmd.com/read/28580737/pragmatic-approach-to-chest-pain-patients-discharged-with-undetectable-high-sensitivity-troponin-t-and-normal-electrocardiogram-the-stabs-ct-protocol
#20
Warrick Bishop, Gary Girao
A strategy that discharges chest pain patients with negative high-sensitivity troponin and non-ischaemic electrocardiography changes may still result in 0.44% of patients experiencing myocardial infarction within 30 days. We observed that a pragmatic approach that systematically discharged 25 patients on cardio-protective medications of aspirin, metoprolol and atorvastatin followed with prompt (<10 days) coronary computed tomography angiography resulted in no major adverse cardiac event and adverse drug reaction 30 days post-presentation...
June 2017: Internal Medicine Journal
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