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https://www.readbyqxmd.com/read/28208610/non-emergency-medical-transportation-needs-of-middle-aged-and-older-adults-a-rural-urban-comparison-in-delaware-usa
#1
Matthew Lee Smith, Thomas R Prohaska, Kara E MacLeod, Marcia G Ory, Amy R Eisenstein, David R Ragland, Cheryl Irmiter, Samuel D Towne, William A Satariano
Background: Older adults in rural areas have unique transportation barriers to accessing medical care, which include a lack of mass transit options and considerable distances to health-related services. This study contrasts non-emergency medical transportation (NEMT) service utilization patterns and associated costs for Medicaid middle-aged and older adults in rural versus urban areas. Methods: Data were analyzed from 39,194 NEMT users of LogistiCare-brokered services in Delaware residing in rural (68.3%) and urban (30...
February 10, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28202161/complication-profile-failure-to-rescue-and-mortality-following-elective-endovascular-aortic-aneurysm-repair
#2
David S Kauvar, Eric D Martin, Todd E Simon, Matthew D Givens
INTRODUCTION: Understanding the relationship between patient risk factors, postoperative complications, and morbidity and mortality is important when considering elective endovascular aortic aneurysm repair (E-EVAR) performed to prevent aneurysm rupture mortality. We aimed to stratify complications in E-EVAR and explore their relationship with postoperative death. METHODS: E-EVAR cases from 2012 NSQIP were identified. 30-day complications were categorized as major (MAJCX) or minor (MINCX) using the Clavien-Dindo classification...
February 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28185299/incremental-hemodialysis-a-european-perspective
#3
Kamonwan Tangvoraphonkchai, Andrew Davenport
Most patients initiating hemodialysis have residual renal function (RRF). Whereas RRF is monitored prior to commencing hemodialysis, once dialysis is started most centres simply rely on dialyzer urea clearance to determine adequate uremic toxin clearance and disregard the effect of RRF. However sustaining RRF is important for the dialysis patient, as RRF reduces inter-dialytic weight gains, increases middle molecule and protein bound toxin clearances and is associated with better quality of life assessments...
February 9, 2017: Seminars in Dialysis
https://www.readbyqxmd.com/read/28183858/comparison-of-topical-chlorhexidine-and-mupirocin-for-the-prevention-of-exit-site-infection-in-incident-peritoneal-dialysis-patients
#4
Htay Htay, David W Johnson, Sin Yan Wu, Elizabeth L Oei, Marjorie Wai Yin Foo, Jason C Choo
♦ Objective: Prevention of exit-site infection (ESI) is of paramount importance to peritoneal dialysis (PD) patients. The aim of this study was to evaluate the effectiveness of chlorhexidine in the prevention of ESI in incident PD patients compared with mupirocin. ♦ Methods: This retrospective, pre-test/post-test observational study included all incident PD patients at Singapore General Hospital from 2012 to 2015. Patients received daily topical exit-site application of either mupirocin (2012 - 2013) or chlorhexidine (2014 - 2015) in addition to routine exit-site cleaning with 10% povidone-iodine...
February 9, 2017: Peritoneal Dialysis International: Journal of the International Society for Peritoneal Dialysis
https://www.readbyqxmd.com/read/28169946/differences-in-utilization-of-life-support-and-end-of-life-care-for-medical-icu-patients-with-versus-without-cancer
#5
Geoffrey Koff, Urvashi Vaid, Edward Len, Albert Crawford, David A Oxman
OBJECTIVES: To explore differences in the utilization of life support and end-of-life care between patients dying in the medical ICU with cancer compared with those without cancer. DESIGN: Retrospective review of 403 deaths or hospice transfers in the medical ICU from January 1, 2012, to June 30, 2013. SETTING: Urban tertiary care university hospital. PATIENTS: Consecutive medical ICU deaths or hospice transfers over an 18-month period...
February 6, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28160763/the-use-of-complementary-and-alternative-medicine-by-patients-undergoing-hemodialysis
#6
Özlem Ceyhan, Songul Göris, Nevin Dogan, Sevda Korkut Bayındır
Context • Hemodialysis (HD) is a frequently used method for the treatment of chronic renal failure. Patients show many symptoms and problems, depending on the success of HD and the disease. Today, one of the most commonly used methods, in addition to pharmacological treatments, for ensuring symptom control and reinforcing a patient's well-being is complementary and alternative medicine (CAM). Objectives • The study was conducted to determine the benefits of the use of CAM for patients undergoing HD. Design • The study was descriptive...
January 2017: Alternative Therapies in Health and Medicine
https://www.readbyqxmd.com/read/28152289/cqi-proiect-every-other-day-nocturnal-hhd-an-alternative-approach-to-reduce-burden
#7
(no author information available yet)
More frequent dialysis, typically performed five to six times per week at home, has been associated with a num- ber of clinical, cardiovascular, and health-related quality of life (HRQOL) benefits. Daily therapy often results in a burden for patients and care partners. A continuous qual- ity improvement (CQI) initiative was conducted to evaluate if an alternate day, longer duration therapy (3.5 treatments with six to 10 hour treatments per week) would provide a viable alternative for home hemodialysis (HHD)...
August 2016: Nephrology News & Issues
https://www.readbyqxmd.com/read/28134619/functional-bowel-disorders-and-associated-risk-factors-in-hemodialysis-patients-in-turkey
#8
Edip Gökalp Gök, Ayça İnci, Melahat Çoban, Dilek Aslan Kutsal, Seyhun Kürşat
BACKGROUND/AIMS: Functional bowel disorders (FBDs) impair the quality of life in patients with end-stage renal disease (ESRD). The aim of our study was to determine the prevalence and distribution of the subtypes of FBDs in hemodialysis (HD) patients. MATERIALS AND METHODS: This prospective, cross-sectional study included 80 patients who received HD for more than 3 months (patient group) and 80 healthy controls (control group). FBDs were diagnosed according to the Rome II diagnostic criteria by excluding organic pathologies...
January 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28126707/acceptance-of-antidepressant-treatment-by-patients-on-hemodialysis-and-their-renal-providers
#9
Julio E Pena-Polanco, Maria K Mor, Fadi A Tohme, Michael J Fine, Paul M Palevsky, Steven D Weisbord
BACKGROUND AND OBJECTIVES: Depression is common in patients receiving chronic hemodialysis but seems to be ineffectively treated. We investigated the acceptance of antidepressant treatment by patients on chronic hemodialysis and their renal providers. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: As part of a clinical trial of symptom management in patients on chronic hemodialysis conducted from 2009 to 2011, we assessed depression monthly using the Patient Health Questionnaire 9...
February 7, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28124305/calcification-in-arteriovenous-fistula-blood-vessels-may-predict-arteriovenous-fistula-failure-a-5-year-follow-up-study
#10
Aleksandar Jankovic, Tatjana Damjanovic, Zivka Djuric, Jelena Marinkovic, Georg Schlieper, Petar Djuric, Jelena Tosic Dragovic, Ana Bulatovic, Milos Mitrovic, Jovan Popovic, Jürgen Floege, Nada Dimkovic
PURPOSE: Arteriovenous fistula (AVF) is the preferred vascular access for hemodialysis. The impact of vascular calcification process on AVF survival remains unclear and results of several studies about this issue are controversial. In the light of the new knowledge about the different susceptibility for calcification process in different blood vessels, the aim of our study was to analyze whether the calcification of AVF-blood vessels may have an impact on AVF longevity. METHODS: The study included 90 patients, 49 males and 41 females, all of them Caucasians, with a mean age 62 ± 11 years, on regular hemodialysis for more than 1 year with patent primary AVFs...
January 25, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28123593/epidemiology-of-cancer-in-end-stage-renal-disease-dialysis-patients-a-national-cohort-study-in-taiwan
#11
Chih-Chiang Chien, Ming-Ming Han, Yu-Hsien Chiu, Jhi-Joung Wang, Chin-Chen Chu, Chien-Ya Hung, Yih-Min Sun, Nai-Cheng Yeh, Chung-Han Ho, Chih-Ching Lin, Hao-Yun Kao, Shih-Feng Weng
The incidence and mortality of site-specific cancers in patients with end-stage renal disease (ESRD) on maintenance dialysis have been rarely studied for Asian populations. We tapped Taiwan`s National Health Insurance Research Database to identify and recruit patients starting maintenance dialysis between 1999 and 2004. They were followed from initiation of dialysis until death, discontinuation of dialysis, or the end of 2008. We calculated the survival rate and mortality risk of dialysis patients with cancer...
2017: Journal of Cancer
https://www.readbyqxmd.com/read/28110907/trends-in-patient-safety-of-intact-abdominal-aortic-aneurysm-repair-german-registry-data-on-36-594-procedures
#12
M Trenner, B Haller, M Storck, B Reutersberg, M A Kallmayer, H-H Eckstein
OBJECTIVE/BACKGROUND: The study aim was to determine whether patient safety for non-ruptured abdominal aortic aneurysm (nrAAA) repair has changed between 1999 and 2010 in a large German cohort. METHODS: The data source was the prospective quality assurance registry of the German Vascular Society from 1999 to 2010. Patient characteristics, surgical techniques (open aortic repair [OAR], endovascular aortic repair [EVAR]), procedural time and outcomes, including the length of hospital stay (LOS), were analysed using the Cochran-Armitage test for binary parameters and Spearman's correlation coefficient for quantitative parameters...
January 19, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28104158/incidence-and-risk-factors-of-persistent-hyperparathyroidism-after-kidney-transplantation
#13
K Nakai, H Fujii, T Ishimura, M Fujisawa, S Nishi
Persistent hyperparathyroidism after kidney transplantation is related to graft function, but pre-transplantation risk factors of persistent hyperparathyroidism have not been evaluated in detail. We enrolled 86 patients who had undergone kidney transplantation between 2008 and 2014. Nine patients showed persistent hyperparathyroidism characterized by the following: 1) serum parathyroid hormone levels >65 pg/mL and serum calcium levels >10.5 mg/dL at 1 year after kidney transplantation; 2) parathyroidectomy after kidney transplantation; and 3) reintroduction of cinacalcet after kidney transplantation...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28104156/long-term-outcomes-in-kidney-transplantation-from-expanded-criteria-donors-after-circulatory-death
#14
Y Tomita, T Tojimbara, K Iwadoh, I Nakajima, S Fuchinoue
The number of recipients waiting for a transplant is increasing. In Japan, there is more frequent use of organs from expanded-criteria donors (ECDs) after circulatory death. We retrospectively analyzed long-term outcomes of kidney transplantation (KT) from expanded-criteria donation after circulatory death (DCD). From 1995 to 2013, 97 cases of KT from DCD donors were performed in our department. Death-censored graft survival rates of ECD kidneys (n = 50) versus standard-criteria deceased-donor (SCD) kidneys (n = 47) for 1, 5, and 10 years after transplantation were 84...
January 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/28095805/vascular-access-placement-in-patients-with-chronic-kidney-disease-stages-4-and-5-attending-an-inner-city-nephrology-clinic-a-cohort-study-and-survey-of-providers
#15
Narender Goel, Caroline Kwon, Teena P Zachariah, Michael Broker, Vaughn W Folkert, Carolyn Bauer, Michal L Melamed
BACKGROUND: The majority of incident hemodialysis (HD) patients initiate dialysis via catheters. We sought to identify factors associated with initiating hemodialysis with a functioning arterio-venous (AV) access. METHODS: We conducted a retrospective chart review of all adult patients, age >18 years seeing a nephrologist with a diagnosis of CKD stage 4 or 5 during the study period between 06/01/2011 and 08/31/2013 to evaluate the placement of an AV access, initiation of dialysis and we conducted a survey of providers about the process...
January 17, 2017: BMC Nephrology
https://www.readbyqxmd.com/read/28094484/a-simplified-screening-tool-to-identify-seriously-ill-patients-in-the-emergency-department-for-referral-to-a-palliative-care-team
#16
Paolo Cotogni, Anna DE Luca, Andrea Evangelista, Claudia Filippini, Renata Gili, Antonio Scarmozzino, Giovannino Ciccone, Luca Brazzi
BACKGROUND: The aims of this study were to evaluate the feasibility of an Emergency Department (ED)-initiated screening to identify seriously ill patients in need of palliative care (PC) and to develop a simplified screening tool (SST). METHODS: Eligible patients with known diagnosis of chronic heart, lung, liver, and kidney failures, progressive neurological diseases or advanced cancer, awaiting to be hospitalized after an ED-visit, were assessed with the screening tool from the Italian Society Anaesthesia Analgesia Resuscitation Intensive Care (SIAARTI)...
January 17, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28090010/long-term-outcomes-after-percutaneous-lower-extremity-arterial-interventions-with-atherectomy-vs-balloon-angioplasty%C3%A3-propensity-score-matched-registry
#17
Adam Janas, Piotr P Buszman, Krzysztof P Milewski, Szymon Wiernek, Ksenia Janas, Maciej Pruski, Wojciech Wojakowski, Aleksandra Błachut, Wojciech Picheta, Pawel Buszman, Stefan Kiesz
BACKGROUND: The impact of endovascular revascularization of the lower extremity arteries with atherectomy (AT) compared with percutaneous transluminal angioplasty (PTA) is still unclear. Therefore, the aim of the study was to compare long-term outcomes after percutaneous PTA and AT in patients requiring endovascular revascularization.Methods and Results:This was a single-center, retrospective registry of obstructive and symptomatic PAD patients who underwent endovascular revascularization...
January 14, 2017: Circulation Journal: Official Journal of the Japanese Circulation Society
https://www.readbyqxmd.com/read/28089366/limited-reduction-in-uremic-solute-concentrations-with-increased-dialysis-frequency-and-time-in-the-frequent-hemodialysis-network-daily-trial
#18
Tammy L Sirich, Kara Fong, Brett Larive, Gerald J Beck, Glenn M Chertow, Nathan W Levin, Alan S Kliger, Natalie S Plummer, Timothy W Meyer
The Frequent Hemodialysis Network Daily Trial compared conventional three-times weekly treatment to more frequent treatment with a longer weekly treatment time in patients receiving in-center hemodialysis. Evaluation at one year showed favorable effects of more intensive treatment on left ventricular mass, blood pressure, and phosphate control, but modest or no effects on physical or cognitive performance. The current study compared plasma concentrations of uremic solutes in stored samples from 53 trial patients who received three-times weekly in-center hemodialysis for an average weekly time of 10...
January 12, 2017: Kidney International
https://www.readbyqxmd.com/read/28088773/epidemiology-and-outcome-of-acute-pancreatitis-in-end-stage-renal-disease-dialysis-patients-a-10-year-national-cohort-study
#19
Hung-Jui Chen, Jhi-Joung Wang, Wen-Ing Tsay, Shwu-Huey Her, Cheng-Heng Lin, Chih-Chiang Chien
BACKGROUND: The objective of this study is to determine the incidence and severity of acute pancreatitis (AP) in patients with end-stage renal disease (ESRD) on dialysis and whether the dialysis modality [hemodialysis (HD) versus peritoneal dialysis (PD)] confers a higher risk for AP as well as complications or mortality related to AP. METHODS: We analyzed national health insurance claims data of 67 078 ESRD patients initiating dialysis between 1999 and 2007 in Taiwan...
January 14, 2017: Nephrology, Dialysis, Transplantation
https://www.readbyqxmd.com/read/28086826/offering-patients-therapy-options-in-unplanned-start-options-implementation-of-an-educational-program-is-feasible-and-effective
#20
Anna Machowska, Mark Dominik Alscher, Satyanarayana Reddy Vanga, Michael Koch, Michael Aarup, Abdul Rashid Qureshi, Bengt Lindholm, Peter Rutherford
BACKGROUND: Patients with unplanned dialysis start (UPS) have worse clinical outcomes than non-UPS patients, and receive peritoneal dialysis (PD) less frequently. In the OPTiONS study of UPS patients, an educational programme (UPS-EP) aiming at improving care of UPS patients by facilitating care pathways and enabling informed choice of dialysis modality was implemented. We here report on impact of UPS-EP on modality choice and clinical outcomes in UPS patients. METHODS: This non-interventional, prospective, multi-center, observational study included 270 UPS patients from 26 centers in 6 European countries (Austria, Germany, Denmark, France, United Kingdom and Sweden) who prior to inclusion presented acutely, or were being followed by nephrologists but required urgent dialysis commencement by an acutely placed CVC or PD catheter...
January 13, 2017: BMC Nephrology
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