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Diabetic And hospital discharge

Rosa Agra-Bermejo, Alberto Cordero, Moisés Rodríguez-Mañero, Jose M García Acuña, Belén Álvarez Álvarez, Álvaro Martínez, Leyre Álvarez Rodríguez, Charigan Abou-Jokh, Belén Cid Álvarez, Jose Ramón González-Juanatey
BACKGROUND: Recent studies suggest that the benefit of mineralocorticoid receptor antagonists in the acute coronary syndrome setting is controversial. The aim of this study was to examine the current long-term prognostic benefit of mineralocorticoid receptor antagonists in patients with acute coronary syndrome. MATERIAL AND METHODS: We conducted a retrospective cohort study of 8318 consecutive acute coronary syndrome patients. Baseline patient characteristics were examined and a follow-up period was established for registry of death, major cardiovascular adverse events and heart failure re-hospitalization...
August 17, 2018: European Heart Journal. Acute Cardiovascular Care
Ravi Iyengar, Jennifer Franzese, Roma Gianchandani
PURPOSE OF THIS REVIEW: Chronic diabetic nephropathy and renal dysfunction from other causes are common in hospitalized patients with diabetes. Available diabetes management guidelines aim to reduce hyperglycemia and hypoglycemia, both independent risk factors for hospital outcomes. Renal dysfunction, which increases the risk of hypoglycemia, adds a layer of complexity in diabetes management. Therefore, modified glucose goals and treatment regimens may be required. RECENT FINDINGS: Recent prospective and retrospective studies provide direction on safe insulin therapy for diabetes inpatients with renal compromise...
August 15, 2018: Current Diabetes Reports
Chia-Po Fu, Wayne H-H Sheu, Wen-Lieng Lee, Wen-Jane Lee, Jun-Sing Wang, Shih-Yi Lin, I-Te Lee
INTRODUCTION: Postprandial hyperglycemia plays a pivotal role in cardiovascular disease. However, few studies have investigated associations between the severity of coronary artery disease (CAD) and postprandial glucose levels in angina patients without known diabetes before coronary angiography. METHODS: Subjects who were admitted for coronary angiography due to angina and were in stable condition after discharge were recruited. A standard 75-g oral glucose tolerance test (OGTT) was performed at outpatient visits approximately 2-4 weeks after hospital discharge, and fasting and post-challenge blood glucose were measured...
2018: PloS One
Mohammad Akhtar Hussain, Judith M Katzenellenbogen, Frank M Sanfilippo, Kevin Murray, Sandra C Thompson
BACKGROUND: Hospitalisation for atherothrombotic disease (ATD) is expected to rise in coming decades. However, increasingly, associated comorbidities impose challenges in managing patients and deciding appropriate secondary prevention. We investigated the prevalence and pattern of multimorbidity (presence of two or more chronic conditions) in Aboriginal and non-Aboriginal Western Australian residents with ATDs. METHODS AND FINDINGS: We used population-based de-identified linked administrative health data from 1 January 2000 to 30 June 2014 to identify a cohort of patients aged 25-59 years admitted to Western Australian hospitals with a discharge diagnosis of ATD...
2018: PloS One
Viktor Rotbain Curovic, Tine W Hansen, Mie K Eickhoff, Bernt Johan von Scholten, Henrik Reinhard, Peter Karl Jacobsen, Frederik Persson, Hans-Henrik Parving, Peter Rossing
AIMS: Urinary levels of kidney injury molecule 1 (u-KIM-1) and neutrophil gelatinase-associated lipocalin (u-NGAL) reflect proximal tubular pathophysiology and have been proposed as risk markers for development of complications in patients with type 2 diabetes (T2D). We clarify the predictive value of u-KIM-1 and u-NGAL for decline in eGFR, cardiovascular events (CVE) and all-cause mortality in patients with T2D and persistent microalbuminuria without clinical cardiovascular disease. METHODS: This is a prospective study that included 200 patients...
August 14, 2018: Acta Diabetologica
Carmen M Lara-Rojas, Luis M Pérez-Belmonte, María D López-Carmona, Ricardo Guijarro-Merino, María R Bernal-López, Ricardo Gómez-Huelgas
AIMS: To analyze national trends in the rates of hospitalizations (all-cause and by principal discharge diagnosis) in total diabetic population of Spain. METHODS: We carried out a nation-wide population-based study of all diabetic patients hospitalized between 1997 and 2010. All-cause hospitalizations, hospitalizations by principal discharge diagnosis, mean age, Charlson Comorbidity Index, readmission rates and length of hospital stay were examined. Annual rates adjusted for age and sex were analyzed and trends were calculated...
August 9, 2018: European Journal of Internal Medicine
Sridhara Sastry Yaddanapudi, Maria Carissa Pineda, David W Boorman, Richard E Bryne, Krista Lim Hing, Sunil Sharma
INTRODUCTION: Obstructive sleep apnea (OSA) is a well-known risk factor for stroke. This is attributed to multiple mechanisms such as endothelial dysfunction, atrial fibrillation, hypertension, and comorbid obesity. STOP questionnaire alone is unreliable to diagnose OSA and in-hospital sleep study is costly and can be technically challenging. We used high-resolution pulse oximetry (HRPO) to test the feasibility of screening for OSA and predicting outcome. METHODS: Data from 115 stroke patients who underwent HRPO was collected including Oxygen desaturation index (ODI) <4%, pulse rate, arterial oxygen saturation (SaO2 ), and time spent at SaO2 saturation <88%...
August 7, 2018: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
Alexandra L Martin, J Ryan Stewart, Harshitha Girithara-Gopalan, Jeremy T Gaskins, Nicole J McConnell, Erin E Medlin
OBJECTIVES: The objective of this study was to determine complications associated with primary closure compared with reconstruction after vulvar excision and predisposing factors to these complications. METHODS: Patients undergoing vulvar excision with or without reconstruction from 2011 to 2015 were abstracted from the National Surgical Quality Improvement Program database. Common Procedural Terminology codes were used to characterize surgical procedures as vulvar excision alone or vulvar excision with reconstruction...
August 7, 2018: International Journal of Gynecological Cancer
E Leibovitz, J Wainstein, M Boaz
AIM: To study the association between serum albumin and cholesterol levels at hospital admission and incident hypoglycaemia among people admitted to internal medicine units. METHODS: In this cross-sectional analysis, we examined the electronic medical records of people hospitalized in internal medicine departments. Data extracted included all glucose measurements as well as serum albumin and cholesterol, which were measured upon admission. A hypoglycaemia event was recorded for a given person if at least one glucose measurement of ≤ 3...
August 8, 2018: Diabetic Medicine: a Journal of the British Diabetic Association
Mohammad A Hossain, Ami Amin, Anju Paul, Huzaif Qaisar, Monika Akula, Alireza Amirpour, Shreya Gor, Sofi Giglio, Jennifer Cheng, Roy Mathew, Tushar Vachharajani, Mohamed Bakr, Arif Asif
BACKGROUND: While obesity is a chronic condition that predisposes patients to other more serious disorders, the prevalence and the documentation of obesity as diagnosis has not been extensively studied in hospitalized patients. We conducted a retrospective chart review to investigate the prevalence and documentation of obesity as a diagnosis among patients admitted to our medical center. METHOD: IRB approval was obtained for this retrospective study. Body mass index (BMI) as per CDC, admission and discharge diagnosis of obesity and common comorbidities (hypertension, diabetes, hyperlipidemia, coronary artery disease, congestive heart disease, chronic kidney disease and chronic obstructive pulmonary disease) were recorded...
August 7, 2018: Journal of Clinical Medicine
Xian-Liang Liu, Chiung-Jung Jo Wu, Karen Willis, Yan Shi, Maree Johnson
This study examined the impact of inpatient education on diabetes knowledge, acute coronary syndrome (ACS) symptom management and diabetes self-management on discharge for patients with ACS and type 2 diabetes mellitus (T2DM). A cross-sectional survey and patient health record review of 160 patients was conducted in a major hospital in Shanghai. Patient education received was measured using a visual analogue scale. The survey included valid and reliable measures of diabetes knowledge, self-efficacy, attitudes to ACS and clinical outcomes...
July 31, 2018: Health Education Research
Leo Niskanen, Jarmo Hahl, Jari Haukka, Elli Leppä, Tatu Miettinen, Vasili Mushnikov, Raija Sipilä, Nadia Tamminen, Pia Vattulainen, Pasi Korhonen
AIM: To identify how the electronic health record (EHR) systems and national registers can be used for research purposes. We focused on how the primary care physicians adhere to clinical guidelines. METHODS: Study population included incident type 2 diabetes patients from four selected regions. Data were collected in two phases. At the first phase study cohort was identified using the prescription registers of the Social Insurance Institution (SII) and EHR systems used within the study regions...
August 6, 2018: Acta Diabetologica
William N Mkanta, Michelle C Reece, Abeer D Alamri, Emmanuel U Ezekekwu, Aishwarya Potluri, Neale R Chumbler
Introduction: Although diabetes is one of the leading chronic disease in the country, efforts in primary care and patient self-care management could prevent most of the diabetes-related hospitalizations and produce cost savings and improvements in quality of life. We used information from Medicaid beneficiaries in 3 states to predict racial differences in diabetes hospitalizations and demonstrate how they vary across states. Methods: We conducted a cross-sectional study to examine differences between black and white patients with diabetes hospitalizations...
January 2018: Health Services Research and Managerial Epidemiology
Stephanie Attard Camilleri, Juanita Camilleri Casingena, Kentaro Yamagata, Martin Balzan
Background: Understanding positive and negative influences on adult immunization status can help healthcare providers to better identify and target patients who are likely to need immunization. Our aim was to assess and compare influenza and pneumococcal (IV/PV) immunisation rates to identify vaccination predictors in Malta. Method: One group consisted of all medical patients discharged from Mater Dei Hospital (MDH) over a one week period in February 2013. Patients were administered a phone questionnaire...
2018: Multidisciplinary Respiratory Medicine
Gennaro Giustino, Lisandro D Colantonio, Todd M Brown, April P Carson, Yuling Dai, Michael E Farkouh, Keri L Monda, Paul Muntner, Robert S Rosenson
BACKGROUND: Patients with diabetes mellitus (DM) have a high risk for cardiovascular disease (CVD) events after an acute myocardial infarction (AMI). High-intensity statins reduce CVD risk following AMI among patients with and without DM. METHODS: We determined the proportion of Medicare beneficiaries 66 to 75 years of age taking a low/moderate-intensity statin with (n = 6718) and without (n = 6414) DM who titrated to a high-intensity statin dosage (i.e...
August 4, 2018: Cardiovascular Drugs and Therapy
Yusi Gong, Faith Selzer, Bhushan Deshpande, Elena Losina
OBJECTIVE: To evaluate trends in the utilization, clinical characteristics, and inpatient outcomes among persons with knee osteoarthritis undergoing bariatric surgery. METHOD: We used the National Inpatient Sample to examine trends of bariatric surgeries performed on adults with clinically documented knee osteoarthritis between 2005-2014. We abstracted hospital setting, procedure, demographic and clinical characteristics, and inpatient surgical outcomes from each discharge...
July 31, 2018: Osteoarthritis and Cartilage
Huy Q Truong, Hamid Borghei-Razavi, Edinson Najera, Ana Carolina Igami Nakassa, Eric W Wang, Carl H Snyderman, Paul A Gardner, Juan C Fernandez-Miranda
OBJECTIVE The endoscopic endonasal transcavernous approach with interdural pituitary transposition provides surgical access to the posterior clinoids and interpeduncular cistern. Prior to posterior clinoidectomy, selective coagulation and transection of the inferior hypophyseal artery (IHA) is recommended to prevent uncontrolled tearing of the artery and its avulsion from the wall of the cavernous carotid artery. The authors' preliminary experience has shown that unilateral sacrifice of the IHA caused no permanent endocrine dysfunction...
August 3, 2018: Journal of Neurosurgery
Scott M Pappada, Karina Woodling, Mohammad Hamza Owais, Evan M Zink, Layth Dahbour, Ravi S Tripathi, Sadik A Khuder, Thomas J Papadimos
OBJECTIVE: Hyperglycemia is an independent risk factor in hospitalized patients for adverse outcomes, even if patients are not diabetic. We used continuous glucose monitoring to evaluate whether glycemic control (hyperglycemia) in the first 72 h after an intensive care admission was associated with the need for admission to a post discharge long-term medical facility. RESULTS: We enrolled 59 coronary artery bypass grafting patients. Poor glycemic control was defined as greater than 33% of continuous glucose monitoring values < 70 and > 180 mg/dL (group 1); and then these patients were reevaluated with a less strict definition of poor glycemic control with greater than 25% of continuous glucose values < 70 and > 180 mg/dL (group 2)...
July 31, 2018: BMC Research Notes
Daniel Cunningham, Vasili Karas, James DeOrio, James Nunley, Mark Easley, Samuel Adams
BACKGROUND: The Comprehensive Care for Joint Replacement (CJR) model provides bundled payments for in-hospital care and care within 90 days following discharge for Medicare beneficiaries undergoing lower-extremity joint replacement involving the hip, knee, or ankle (total hip arthroplasty, total knee arthroplasty, or total ankle arthroplasty [TAA]). The study hypothesis was that patient comorbidities are associated with readmissions, emergency department (ED) utilization, and subspecialist wound-healing consultation, which are examples of costly contributors to postoperative health-care spending...
August 1, 2018: Journal of Bone and Joint Surgery. American Volume
Puja Kohli, Pedro V Staziaki, Sumbal A Janjua, Daniel A Addison, Travis R Hallett, Orla Hennessy, Richard A P Takx, Michael T Lu, Florian J Fintelmann, Marc Semigran, Robert S Harris, Bartolome R Celli, Udo Hoffmann, Tomas G Neilan
Heart Failure (HF) and chronic obstructive pulmonary disease (COPD) are morbid diseases that often coexist. In patients with coexisting disease, COPD is an independent risk factor for readmission and mortality. However, spirometry is often inaccurate in those with active heart failure. Therefore, we investigated the association between the presence of emphysema on computed tomography (CT) and readmission rates in smokers admitted with heart failure (HF). The cohort included a consecutive group of smokers discharged with HF from a tertiary center between January 1, 2014 and April 1, 2014 who also had a CT of the chest for dyspnea...
2018: PloS One
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