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https://www.readbyqxmd.com/read/28918412/prediction-of-early-unplanned-intensive-care-unit-readmission-in-a-uk-tertiary-care-hospital-a-cross-sectional-machine-learning-approach
#1
Thomas Desautels, Ritankar Das, Jacob Calvert, Monica Trivedi, Charlotte Summers, David J Wales, Ari Ercole
OBJECTIVES: Unplanned readmissions to the intensive care unit (ICU) are highly undesirable, increasing variance in care, making resource planning difficult and potentially increasing length of stay and mortality in some settings. Identifying patients who are likely to suffer unplanned ICU readmission could reduce the frequency of this adverse event. SETTING: A single academic, tertiary care hospital in the UK. PARTICIPANTS: A set of 3326 ICU episodes collected between October 2014 and August 2016...
September 15, 2017: BMJ Open
https://www.readbyqxmd.com/read/28917219/reuma-pt-contribution-to-the-knowledge-of-immune-mediated-systemic-rheumatic-diseases
#2
Maria José Santos, Helena Canhão, Ana Filipa Mourão, Filipa Oliveira Ramos, Cristina Ponte, Cátia Duarte, Anabela Barcelos, Fernando Martins, José António Melo Gomes
Patient registries are key instruments aimed at a better understanding of the natural history of diseases, at assessing the effectiveness of therapeutic interventions, as well as identifying rare events or outcomes that are not captured in clinical trials. However, the potential of registries goes far beyond these aspects. For example, registries promote the standardization of clinical practice, can also provide information on domains that are not routinely collected in clinical practice and can support decision-making...
September 14, 2017: Acta Reumatológica Portuguesa
https://www.readbyqxmd.com/read/28916953/dexlansoprazole-for-heartburn-relief-in-adolescents-with-symptomatic-nonerosive-gastro-esophageal-reflux-disease
#3
Benjamin D Gold, Betsy Pilmer, Jaroslaw Kierkuś, Barbara Hunt, Maria Claudia Perez, David Gremse
BACKGROUND: Proton pump inhibitors are commonly used to treat gastro-esophageal reflux disease (GERD) and nonerosive GERD (NERD) in adolescents and adults. Despite the efficacy of available medications, many patients have persisting symptoms, indicating a need for more effective agents. AIMS: To assess the safety and efficacy of dexlansoprazole dual delayed-release capsules in adolescents for treatment of symptomatic NERD. METHODS: A phase 2, open-label, multicenter study was conducted in adolescents aged 12-17 years...
September 15, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/28916485/moderate-intravenous-sedation-for-first-trimester-surgical-abortion-a-comparison-of-adverse-outcomes-between-obese-and-normal-weight-women
#4
Gillian Horwitz, Danielle Roncari, Kari Braaten, Rie Maurer, Jennifer Fortin, Alisa B Goldberg
OBJECTIVE: To determine if obese women experience increased rates of adverse outcomes with moderate intravenous sedation during first trimester surgical abortion compared to normal weight women. STUDY DESIGN: We performed a retrospective cohort study of all first trimester surgical abortions with moderate intravenous sedation at an outpatient facility between September 2010 and June 2015. The primary outcome was supplemental oxygen administration. Secondary outcomes included reversal agent administration, anesthesia-related adverse events, and intraoperative lowest level of consciousness (LLOC)...
September 13, 2017: Contraception
https://www.readbyqxmd.com/read/28916295/utilization-of-hospice-services-in-a-population-of-patients-with-huntington-s-disease
#5
Margaret O Johnson, Samuel Frank, Matthew Mendlik, David Casarett
CONTEXT: Although the early and middle stages of Huntington's Disease (HD) and its complications have been well described, less is known about the course of late-stage illness. In particular, little is known about the population of patients who enroll in hospice. OBJECTIVES: Our goal is to describe the characteristics of patients with HD who enrolled in hospice. METHODS: Retrospective cohort study of electronic medical record data from 12 not-for-profit hospices in the United States from 2008 to 2012...
September 12, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28916170/the-1h-post-glucose-value-best-predicts-future-dysglycemia-among-normal-glucose-tolerance-subjects
#6
Narasimmal Sai Prasanna, Anandakumar Amutha, Thyparambil Aravindakshan Pramodkumar, Ranjit Mohan Anjana, Ulagamathesan Venkatesan, Miranda Priya, Rajendra Pradeepa, Viswanathan Mohan
AIM: To analyse the OGTT glycemic parameters - fasting, 1h and 2h plasma glucose values singly and in various combinations; with respect to their prediction of future dysglycemia in subjects with normal glucose tolerance (NGT). METHODS: Electronic medical records of individuals who underwent an OGTT between 1991 and 2016 at a tertiary diabetes centre were analysed. NGT subjects who had at least one more follow up OGTT (n=1356) were selected for the study. Regarding their prediction of future dysglycemia, the glycemic parameters-Fasting plasma glucose (FPG), 1h plasma glucose (1HrPG) and 2h plasma glucose (2HrPG) were analysed separately and also in different combinations...
August 1, 2017: Journal of Diabetes and its Complications
https://www.readbyqxmd.com/read/28916030/fellowship-candidate-selection-at-the-best-medical-center-a-novel-process
#7
Philip R Cohen
Dr. Ida Lystic completed her MD degree at the prestigious Harvey Medical School (which has since been renamed the Harvey Provider School) and her residency in internal medicine and gastroenterology fellowship at the OTHER (Owen T. Henry and Eugene Rutherford) Medical Center. She was subsequently hired as an assistant professor at the BEST (Byron Edwards and Samuel Thompson) Medical Center in 2015. After eventually completing an extensive list of employment requirements, she was able to begin seeing patients...
September 2017: Clinics in Dermatology
https://www.readbyqxmd.com/read/28915393/the-comparative-effectiveness-of-noninvasive-and-invasive-ventilation-in-patients-with-pneumonia
#8
Mihaela S Stefan, Aruna Priya, Penelope S Pekow, Tara Lagu, Jay S Steingrub, Nicholas S Hill, Brian H Nathanson, Peter K Lindenauer
PURPOSE: To compare the outcomes of patients hospitalized with pneumonia treated with noninvasive ventilation (NIV) and invasive mechanical ventilation (IMV). MATERIALS AND METHODS: Using the HealthFacts multihospital electronic medical record database, we included patients hospitalized with a diagnosis of pneumonia and treated with NIV or IMV. We developed a propensity model for receipt of initial NIV and assessed the outcomes in a propensity-matched cohort, and in a covariate adjusted and propensity score weighted models...
May 23, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28914563/patients-with-psychological-icpc-codes-in-primary-care-a-case-control-study-investigating-the-decade-before-presenting-with-problems
#9
Luc G Gidding, Mark G Spigt, Geert-Jan Dinant
BACKGROUND: Recognizing patients with psychological problems can be difficult for general practitioners (GPs). Use of information collected in electronic medical records (EMR) could facilitate recognition. OBJECTIVES: To assess relevant EMR parameters in the decade before patients present with psychological problems. METHODS: Exploratory case-control study assessing EMR parameters of 58 228 patients recorded between 2013 and 2015 by 54 GPs...
December 2017: European Journal of General Practice
https://www.readbyqxmd.com/read/28914280/internal-medicine-resident-engagement-with-a-laboratory-utilization-dashboard-mixed-methods-study
#10
Gregory Kurtzman, Jessica Dine, Andrew Epstein, Yevgenly Gitelman, Damien Leri, Miltesh S Patel, Kyra Ryskina
The objective of this study was to measure internal medicine resident engagement with an electronic medical record-based dashboard providing feedback on their use of routine laboratory tests relative to service averages. From January 2016 to June 2016, residents were e-mailed a snapshot of their personalized dashboard, a link to the online dashboard, and text summarizing the resident and service utilization averages. We measured resident engagement using e-mail read-receipts and web-based tracking. We also conducted 3 hour-long focus groups with residents...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28914278/magnitude-of-potentially-inappropriate-thrombophilia-testing-in-the-inpatient-hospital-setting
#11
Eric Mou, Henry Kwang, Jason Hom, Lisa Shieh, Andre Kumar, Ilana Richman, Caroline Berube
Laboratory costs of thrombophilia testing exceed an estimated $650 million (in US dollars) annually. Quantifying the prevalence and financial impact of potentially inappropriate testing in the inpatient hospital setting represents an integral component of the effort to reduce healthcare expenditures. We conducted a retrospective analysis of our electronic medical record to evaluate 2 years' worth of inpatient thrombophilia testing measured against preformulated appropriateness criteria. Cost data were obtained from the Centers for Medicare and Medicaid Services 2016 Clinical Laboratory Fee Schedule...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28913660/weight-gain-in-hormone-receptor-positive-hr-early-stage-breast-cancer-is-it-menopausal-status-or-something-else
#12
Kirsten A Nyrop, Allison M Deal, Jordan T Lee, Hyman B Muss, Seul Ki Choi, Amy Wheless, Lisa A Carey, Shlomit S Shachar
PURPOSE: This study investigates weight trajectories in pre- versus postmenopausal breast cancer (BC) survivors diagnosed with hormone receptor-positive tumors, with a specific focus on discerning menopausal status and type of endocrine treatment (ET) as risk factors for weight gain during ET. METHODS: We conducted a retrospective review of electronic medical records. Descriptive statistics and Chi-squared and t tests were used to compare pre- and postmenopausal women...
September 14, 2017: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/28913492/incorporating-airway-examination-photography-into-the-electronic-record
#13
Joshua W Sappenfield, Nik Gravenstein, Judith M Wishin, Chukwudi Obiora Chiaghana, David Smyth, Brenda G Fahy, Terrie Vasilopoulos, Laurie Davies, F Kayser Enneking
BACKGROUND: Photography of the airway has been used in research to validate preoperative airway assessment and the likelihood of identifying the difficult-to-mask ventilate and/or intubate patient. Up till now, no study has demonstrated the perceived utility of incorporation of airway photographs into the anesthesia preassessment. METHODS: The University of Florida Health Presurgical Clinic routinely incorporates three photographs of all adult patients during their preanesthesia visit...
April 2017: Rom J Anaesth Intensive Care
https://www.readbyqxmd.com/read/28913416/using-focused-laboratory-management-and-quality-improvement-projects-to-enhance-resident-training-and-foster-scholarship
#14
Matthew D Krasowski, Bradley A Ford, J Stacey Klutts, Chris S Jensen, Angela S Briggs, Robert A Robinson, Leslie A Bruch, Nitin J Karandikar
Training in patient safety, quality, and management is widely recognized as an important element of graduate medical education. These concepts have been intertwined in pathology graduate medical education for many years, although training programs face challenges in creating explicit learning opportunities in these fields. Tangibly involving pathology residents in management and quality improvement projects has the potential to teach and reinforce key concepts and further fulfill Accreditation Council for Graduate Medical Education goals for pursuing projects related to patient safety and quality improvement...
January 2017: Acad Pathol
https://www.readbyqxmd.com/read/28912532/chronic-kidney-disease-is-associated-with-poorer-in-hospital-outcomes-in-patients-hospitalized-with-infections-electronic-record-analysis-from-china
#15
Guobin Su, Hong Xu, Gaetano Marrone, Bengt Lindholm, Zehuai Wen, Xusheng Liu, Juan-Jesus Carrero, Cecilia Stålsby Lundborg
Predominantly based on studies from high-income countries, reduced estimated glomerular filtration rate (eGFR) has been associated with increased risk of infections and infection-related hospitalizations (IRHs). We here explore in-hospital outcomes of IRHs in patients with different kidney function. A total of 6,283 adults, not on renal replacement therapy, with a discharge diagnosis of infection, and with an eGFR 1-12 months before index hospitalization, were included from four hospitals in China. We compared in-hospital outcomes (death, intensive care unit (ICU) admission, length of hospital stay (LOHS) and medical expenses), between patients with and without chronic kidney disease (CKD, defined as eGFR ≤ 60 ml/min per 1...
September 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28912200/development-and-validation-of-electronic-quality-measures-to-assess-care-for-patients-with-transient-ischemic-attack-and-minor-ischemic-stroke
#16
Dawn M Bravata, Laura J Myers, Eric Cheng, Mathew Reeves, Fitsum Baye, Zhangsheng Yu, Teresa Damush, Edward J Miech, Jason Sico, Michael Phipps, Alan Zillich, Jason Johanning, Seemant Chaturvedi, Curt Austin, Jared Ferguson, Bailey Maryfield, Kathy Snow, Susan Ofner, Glenn Graham, Rachel Rhude, Linda S Williams, Greg Arling
BACKGROUND: Despite interest in using electronic health record (EHR) data to assess quality of care, the accuracy of such data is largely unknown. We sought to develop and validate transient ischemic attack and minor ischemic stroke electronic quality measures (eQMs) using EHR data. METHODS AND RESULTS: A random sample of patients with transient ischemic attack or minor ischemic stroke, cared for in Veterans Health Administration facilities (fiscal year 2011), was identified...
September 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28912194/assessing-oral-medication-adherence-among-patients-with-type-2-diabetes-mellitus-treated-with-polytherapy-in-a-developed-asian-community-a-cross-sectional-study
#17
Cia Sin Lee, Jane Hwee Mian Tan, Usha Sankari, Yi Ling Eileen Koh, Ngiap Chuan Tan
OBJECTIVES: The disease burden of type 2 diabetes mellitus (T2DM) is rising due to suboptimal glycaemic control leading to vascular complications. Medication adherence (MA) directly influences glycaemic control and clinical consequences. This study aimed to assess the MA of patients with T2DM and identify associated factors. DESIGN: Analysis of data from a cross-sectional survey and electronic medical records. SETTING: Primary care outpatient clinic in Singapore...
September 14, 2017: BMJ Open
https://www.readbyqxmd.com/read/28912038/proton-pump-inhibitor-use-is-associated-with-a-reduced-risk-of-infection-with-intestinal-protozoa
#18
Johnathan M Sheele
OBJECTIVE: Proton pump inhibitors (PPIs) can kill some human protozoan parasites in cell culture better than the drug metronidazole. Clinical data showing an antiprotozoal effect for PPIs are lacking. The objective of the study is to determine if PPI use is associated with a reduced risk of having intestinal parasites. METHODS: We obtained electronic medical record data for all persons who received a stool ova and parasite (O & P) examination at our tertiary care academic medical center in Cleveland, Ohio, between January 2000 and September 2014...
September 11, 2017: Wilderness & Environmental Medicine
https://www.readbyqxmd.com/read/28911961/sociocultural-considerations-in-juvenile-arthritis-a-review
#19
REVIEW
Kimberly A Lewis, Sharon A Brown, Stefano Tiziani, Ruy Carrasco
PROBLEM: Juvenile Arthritis (JA) is one of the most common autoimmune diseases in children. A variety of sociocultural factors that influence health outcomes in children with JA have been examined in previous research. However, clinical guidelines to guide the care of these children lack support because this research has not been systematically examined and synthesized. ELIGIBILITY CRITERIA: Primary research articles from five internet databases were included if they were peer-reviewed articles in English of studies conducted in the U...
September 11, 2017: Journal of Pediatric Nursing
https://www.readbyqxmd.com/read/28910594/concordance-between-common-hypertension-control-algorithms-in-electronic-medical-record-data
#20
Victoria M Nielsen, Amy Bettano, Mark Josephson, Laura Nasuti, W W Sanouri Ursprung
Because quality improvement metrics and treatment guidelines are used to conduct research, evaluate care quality, and assess population health, they should, ideally, align. We used electronic medical record data to analyze variation between blood pressure control estimates calculated by using thresholds derived from National Quality Forum 0018 (NQF 0018) and Joint National Committee (JNC) treatment guidelines in a cohort of patients with hypertension. Percentage of patients with controlled blood pressure derived from each quality improvement or treatment guideline cutoff varied up to 16...
September 14, 2017: Preventing Chronic Disease
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