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Post-discharge interventions

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https://www.readbyqxmd.com/read/29345403/improving-patient-adherence-to-secondary-prevention-medications-6-months-after-an-acute-coronary-syndrome-observational-cohort-study
#1
D B Brieger, C Chow, J Gullick, K Hyun, M D'Souza, T Briffa
BACKGROUND: Most patients are recommended secondary prevention pharmacotherapies following an acute coronary syndrome (ACS). AIMS: To identify predictors of adherence at 6 months and strategies to improve adherence to these therapies. Design and methods Patients in the CONCORDANCE registry who were discharged on evidence-based medications were stratified into those receiving ≥75% ('adherent') or <75% ('non-adherent') of indicated medications at 6 months. Baseline characteristics, hospital and post-discharge care were compared between groups...
January 18, 2018: Internal Medicine Journal
https://www.readbyqxmd.com/read/29333918/modified-second-stage-hughes-tarsoconjunctival-reconstruction-for-lower-eyelid-defects
#2
Shruti Aggarwal, Christopher T Shah, Maria Kirzhner
To describe a novel technique utilizing an amniotic membrane graft (AMT) to create the mucocutaneous portion of the lower eyelid margin in a modified Hughes eyelid reconstruction for secondary revision or prevention of a hyperemic, hypertrophic conjunctival margin with excessive discharge. This was a retrospective, non-comparative interventional study. Thirty consecutive patients who underwent a modified Hughes reconstruction were included. The first step of the reconstruction was performed in a standard fashion using a tarsoconjunctival flap from the ipsilateral upper eyelid...
January 15, 2018: Orbit
https://www.readbyqxmd.com/read/29329628/spirocerca-lupi-induced-oesophageal-neoplasia-predictors-of-surgical-outcome
#3
Paolo Pazzi, Anastasia Kavkovsky, Anna Shipov, Gilad Segev, Eran Dvir
Canine spirocercosis is caused by the nematode Spirocerca lupi. Migration results in oesophageal fibro-inflammatory nodules that may undergo neoplastic transformation. No studies have assessed pre- or post-surgical prognostic indicators in dogs that undergo intervention for S. lupi induced oesophageal neoplasia. This observational, multi-center study aimed to assess the outcome of dogs with Spirocerca induced sarcoma undergoing endoscopic-guided ablation (n = 12) or surgery (n = 18), and identify prognostic indicators...
January 30, 2018: Veterinary Parasitology
https://www.readbyqxmd.com/read/29325786/a-proactive-outreach-intervention-that-decreases-readmission-after-hepatectomy
#4
Nisha Narula, Bradford J Kim, Catherine H Davis, Whitney L Dewhurst, Leigh A Samp, Thomas A Aloia
BACKGROUND: After hepatectomy, 7%-19% of patients are readmitted within 30 days, accounting for substantial cost and poor patient experience. The purpose of this study was to analyze the impact of a proactive outreach intervention on readmissions. METHODS: Consecutive patients undergoing hepatectomy by a single surgeon 2012-2016 were identified in a prospectively maintained database. In August 2013 a postoperative intervention was implemented; an advanced practice provider called each patient within 72 hours of discharge...
January 9, 2018: Surgery
https://www.readbyqxmd.com/read/29321069/gastroenterologist-and-primary-care-perspectives-on-a-post-endoscopy-discharge-policy-impact-on-clinic-wait-times-provider-satisfaction-and-provider-workload
#5
Daniel Selvig, Justin L Sewell, Delphine S Tuot, Lukejohn W Day
BACKGROUND: To reduce unnecessary ambulatory gastroenterology (GI) visits and increase access to GI care, San Francisco Health Network gastroenterologists and primary care providers implemented guidelines in 2013 that discharged certain patients back to primary care after endoscopy with formal written recommendations. This study assesses the longer-term impact of this policy on GI clinic access, workflow, and provider satisfaction. METHODS: An email-based survey assessed gastroenterologist and primary care provider (PCP) opinions about the discharge process...
January 10, 2018: BMC Health Services Research
https://www.readbyqxmd.com/read/29318355/an-enhanced-recovery-after-surgery-eras-protocol-for-ambulatory-anorectal-surgery-reduced-postoperative-pain-and-unplanned-returns-to-care-after-discharge
#6
Aaron B Parrish, Sean M O'Neill, Steven R Crain, Tara A Russell, Deepak K Sonthalia, Vu T Nguyen, Armen Aboulian
BACKGROUND: Ambulatory surgery for anorectal procedures has been proven to be safe and effective. Specific perioperative pathways combining multiple interventions have been shown to optimize recovery and outcomes associated with inpatient colorectal surgery. However, there are no major studies describing and evaluating a standardized protocol for ambulatory anorectal surgery. The purpose of this study was to evaluate the outcomes of a modified enhanced recovery after surgery (ERAS) protocol for ambulatory anorectal surgery...
January 9, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29317154/mobile-integrated-health-to-reduce-post-discharge-acute-care-visits-a-pilot-study
#7
Jennica Siddle, Peter S Pang, Christopher Weaver, Elizabeth Weinstein, Daniel O'Donnell, Thomas P Arkins, Charles Miramonti
BACKGROUND: Mobile Integrated Health (MIH) leverages specially trained paramedics outside of emergency response to bridge gaps in local health care delivery. STUDY OBJECTIVE: To evaluate the efficacy of a MIH led transitional care strategy to reduce acute care utilization. METHODS: This was a retrospective cohort analysis of a quality improvement pilot of patient patients from an urban, single county EMS, MIH transitional care initiative. We utilized a paramedic/social worker (or social care coordinator) dyad to provide in home assessments, medication review, care coordination, and improve access to care...
December 29, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29315941/thromboembolic-prophylaxis-protocol-with-warfarin-after-radiofrequency-catheter-ablation-of-infarct-related-ventricular-tachycardia
#8
Konstantinos C Siontis, Sina Jamé, Ghaith Sharaf Dabbagh, Rakesh Latchamsetty, Krit Jongnarangsin, Fred Morady, Frank M Bogun
INTRODUCTION: Ablation in the left ventricle (LV) is associated with a risk of thromboembolism. There are limited data on the use of specific thromboembolic prophylaxis strategies post-ablation. We aimed to evaluate a thromboembolic prophylaxis protocol after ventricular tachycardia (VT) ablation. METHODS AND RESULTS: The index procedures of 217 patients undergoing ablation for infarct-related VT with open irrigated-tip catheters were included. Patients with large LV endocardial ablation area (> 3 cm between ablation lesions) were started on low-dose, slowly escalating unfractionated heparin (UFH) infusion 8 hours after access hemostasis, followed by 3 months of anticoagulation...
January 9, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29314751/emergency-airway-and-ventilator-procedures-for-community-based-home-care-staff-validation-of-an-educational-program
#9
Ann Marie Ramsey, Sarah Brennan, Adam Stricker, Kurt Riek, Dana Brown, Rachel Gurtowsky, Julie Sturza, Amy Goldstein Filbrun
BACKGROUND: Children discharged home with tracheostomy and chronic mechanical ventilator support are at high risk for complications and adverse events. Private duty nursing and home respiratory care services are a critical support necessary for successful discharge. The literature suggests that there are opportunities for home care staff (HCS) to improve upon the skills necessary to assess and intervene in an emergency thereby increasing the likelihood of improving long-term outcomes...
January 4, 2018: Pediatric Pulmonology
https://www.readbyqxmd.com/read/29306468/mid-term-outcomes-of-chronic-total-occlusion-percutaneous-coronary-intervention-with-subadventitial-vs-intraplaque-crossing-a-systematic-review-and-meta-analysis
#10
Aris Karatasakis, Barbara A Danek, Judit Karacsonyi, Lorenzo Azzalini, Mauro Carlino, Stéphane Rinfret, Minh Vo, Bavana V Rangan, M N Burke, Subhash Banerjee, Emmanouil S Brilakis
BACKGROUND: Some reports have demonstrated increased risk with subadventitial chronic total occlusion (CTO) crossing, whereas others suggest equipoise between subadventitial and intraplaque crossing techniques. We sought to clarify the effect of subadventitial lesion crossing on mid-term outcomes of CTO percutaneous coronary intervention (PCI). METHODS: We conducted a systematic review and meta-analysis of studies reporting post-discharge outcomes after CTO PCI performed via subadventitial vs...
February 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29305272/effect-of-hyperosmolar-therapy-on-outcome-following-spontaneous-intracerebral-hemorrhage-ethnic-racial-variations-of-intracerebral-hemorrhage-erich-study
#11
Manan Shah, Lee Birnbaum, Jennifer Rasmussen, Padmini Sekar, Charles J Moomaw, Jennifer Osborne, Anastasia Vashkevich, Daniel Woo
PURPOSE: We aimed to identify the effect of hyperosmolar therapy (mannitol and hypertonic saline) on outcomes after intracerebral hemorrhage (ICH) in the Ethnic/Racial Variations of Intracerebral Hemorrhage (ERICH) study. METHODS: Comparison of ICH cases treated with hyperosmolar therapy versus untreated cases was performed using a propensity score based on age, initial Glasgow Coma Scale, location of ICH (lobar, deep, brainstem, and cerebellar), log-transformed initial ICH volume, presence of intraventricular hemorrhage, and surgical interventions...
January 3, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29301463/hospitalization-associated-disability-in-older-adults-with-valvular-heart-disease-incidence-risk-factors-and-its-association-with-care-processes
#12
Maren Jonckers, Bastiaan Van Grootven, Ester Willemyns, Miek Hornikx, Anthony Jeuris, Christophe Dubois, Marie-Christine Herregods, Mieke Deschodt
BACKGROUND: The aim of this study was to determine the incidence and recovery of hospitalisation-associated disability (HAD), the associated risk factors, and the link with care processes in patients aged 70 years or older hospitalised with valvular heart disease (VHD). METHODS: Prospective cohort study performed on the cardiology and cardiac surgery units of University Hospitals Leuven, Belgium. HAD was defined as the loss of independence to complete one of the Activities of Daily Living (ADLs) between hospital admission and discharge...
January 4, 2018: Acta Cardiologica
https://www.readbyqxmd.com/read/29296770/osteonecrosis-of-the-femoral-head-in-sickle-cell-disease-prevalence-comorbidities-and-surgical-outcomes-in-california
#13
Oyebimpe Adesina, Ann Brunson, Theresa H M Keegan, Ted Wun
Osteonecrosis of the femoral head (ONFH) is a prevalent complication of sickle cell disease (SCD) that has not been well described in population-based cohort studies. Using California's Office of Statewide Planning and Development discharge databases (1991-2013), we estimated the cumulative incidence of ONFH after accounting for the competing risk of death and used a multivariable Cox proportional hazards regression to identify factors associated with ONFH diagnosis. We also calculated rates of readmissions to the hospital or emergency department within 30 to 90 days of hip replacement surgery...
July 11, 2017: Blood Advances
https://www.readbyqxmd.com/read/29289941/azithromycin-to-prevent-post-discharge-morbidity-and-mortality-in-kenyan-children-a-protocol-for-a-randomised-double-blind-placebo-controlled-trial-the-toto-bora-trial
#14
Patricia B Pavlinac, Benson O Singa, Grace C John-Stewart, Barbra A Richardson, Rebecca L Brander, Christine J McGrath, Kirkby D Tickell, Mary Amondi, Doreen Rwigi, Joseph B Babigumira, Sam Kariuki, Ruth Nduati, Judd L Walson
INTRODUCTION: Child mortality due to infectious diseases remains unacceptably high in much of sub-Saharan Africa. Children who are hospitalised represent an accessible population at particularly high risk of death, both during and following hospitalisation. Hospital discharge may be a critical time point at which targeted use of antibiotics could reduce morbidity and mortality in high-risk children. METHODS AND ANALYSIS: In this randomised, double-blind, placebo-controlled trial (Toto Bora Trial), 1400 children aged 1-59 months discharged from hospitals in Western Kenya, in Kisii and Homa Bay, will be randomised to either a 5-day course of azithromycin or placebo to determine whether a short course of azithromycin reduces rates of rehospitalisation and/or death in the subsequent 6-month period...
December 29, 2017: BMJ Open
https://www.readbyqxmd.com/read/29288616/auspicious-management-of-a-acute-obstructive-left-colon-tumor-in-a-93-year-old-patient-case-report-and-literature-review
#15
Gabriel Nicolae Andrei, Gabriel Constantinescu, Cristian Nedelcu, Bogdan Cristian Dumitriu, Sebastian Valcea, Mircea Beuran
We present the case of a 93-year-old patient with intestinal occlusion due to a descending colon tumor, with carcinomatous ascites and secondary liver and lung determinations. Considering the risks associated with a surgical act in such a patient and the impossibility of performing a curative intervention, a self-expanding metallic colonic stent was mounted. The post-intervention evolution was favorable, the patient being discharged 48 hours later. Left colon cancer is diagnosed in the occlusive phase in 8 to 26% of cases (1)...
November 2017: Chirurgia
https://www.readbyqxmd.com/read/29284738/comparison-of-risk-factor-control-in-the-year-after-discharge-for-ischemic-stroke-versus-acute-myocardial-infarction
#16
Dawn M Bravata, Joanne Daggy, Jared Brosch, Jason J Sico, Fitsum Baye, Laura J Myers, Christianne L Roumie, Eric Cheng, Jessica Coffing, Greg Arling
BACKGROUND AND PURPOSE: The Veterans Health Administration has engaged in quality improvement to improve vascular risk factor control. We sought to examine blood pressure (<140/90 mm Hg), lipid (LDL [low-density lipoprotein] cholesterol <100 mg/dL), and glycemic control (hemoglobin A1c <9%), in the year post-hospitalization for acute ischemic stroke or acute myocardial infarction (AMI). METHODS: We identified patients who were hospitalized (fiscal year 2011) with ischemic stroke, AMI, congestive heart failure, transient ischemic attack, or pneumonia/chronic obstructive pulmonary disease...
December 28, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29284572/self-perceived-participation-and-autonomy-at-1-year-post-stroke-a-part-of-the-stroke-arm-longitudinal-study-at-the-university-of-gothenburg-salgot-study
#17
Karin Törnbom, Kristin Hadartz, Katharina S Sunnerhagen
BACKGROUND: Identifying factors predicting the long-term outcome of participation and autonomy after stroke is essential for developing individualized rehabilitation interventions. The aim was to describe self-assessed participation and autonomy and to explore factors associated with the same at 1 year post stroke. METHODS: Participants consisted of 79 persons (mean age = 67) with a first-time stroke at the 1-year follow-up. To investigate perceived participation and autonomy at 1 year, a self-assessment questionnaire, the Impact on Participation and Autonomy-English version (IPA-E) was used...
December 25, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/29282418/effect-of-vaginal-hygiene-module-to-attitudes-and-behavior-of-pathological-vaginal-discharge-prevention-among-female-adolescents-in-slemanregency-yogyakarta-indonesia
#18
Sumarah Sumarah, Hesty Widyasih
Objective: To determine the effect of vaginal hygiene module to attitudes and behavior of pathological vaginal discharge prevention in adolescent girls in Sleman Regency, Yogyakarta, Indonesia. Materials and methods: This present study is a quasi experiment with pretest and post-test control group design. A total of 80 female students was selected randomly from two secondary schools at the study site and then distributed equally to control and experimental group. Only participants in the experimental group were given self-learning vaginal hygiene module to maintain vaginal cleanliness...
June 2017: Journal of Family & Reproductive Health
https://www.readbyqxmd.com/read/29282265/does-the-implementation-of-a-novel-intensive-care-discharge-risk-score-and-nurse-led-inpatient-review-tool-improve-outcome-a-prospective-cohort-study-in-two-intensive-care-units-in-the-uk
#19
Jez Fabes, William Seligman, Carolyn Barrett, Stuart McKechnie, John Griffiths
OBJECTIVE: To develop a clinical prediction model for poor outcome after intensive care unit (ICU) discharge in a large observational data set and couple this to an acute post-ICU ward-based review tool (PIRT) to identify high-risk patients at the time of ICU discharge and improve their acute ward-based review and outcome. DESIGN: Retrospective patient cohort of index ICU admissions between June 2006 and October 2011 receiving routine inpatient review. Prospective cohort between March 2012 and March 2013 underwent risk scoring (PIRT) which subsequently guided inpatient ward-based review...
December 26, 2017: BMJ Open
https://www.readbyqxmd.com/read/29282152/safety-and-efficacy-of-inspiratory-muscle-training-for-preventing-adverse-outcomes-in-patients-at-risk-of-prolonged-hospitalisation
#20
Balbino Rivail Ventura Nepomuceno, Mayana de Sá Barreto, Naniane Cidreira Almeida, Caroline Ferreira Guerreiro, Eveline Xavier-Souza, Mansueto Gomes Neto
BACKGROUND: The early institution of inspiratory muscle training on hospitalised patients with no established respiratory deficits could prevent in-hospital adverse outcomes that are directly or indirectly associated to the loss of respiratory muscle mass inherent to a prolonged hospital stay. The objective of the clinical trial is to assess the impact of inspiratory muscle training on hospital inpatient complications. METHODS: This is a double-blind randomised controlled trial...
December 28, 2017: Trials
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