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https://www.readbyqxmd.com/read/29161521/lessons-from-the-camden-coalition-of-healthcare-providers-first-medicaid-shared-savings-performance-evaluation
#1
Aaron Truchil, Natasha Dravid, Stephen Singer, Zachary Martinez, Teagan Kuruna, Scott Waulters
Accountable Care Organizations (ACOs) aim to reduce health care costs while improving patient outcomes. Camden Coalition of Healthcare Providers' (Camden Coalition) work already aligned with this aim before receiving state approval to operate a certified Medicaid ACO in New Jersey. Upon its formation, the Camden Coalition ACO partnered with UnitedHealthcare and, through state legislation, Rutgers Center for State Health Policy (CSHP) was established as its external evaluator. In evaluating the Camden Coalition ACO, Rutgers CSHP built on the Medicare Shared Savings model, but modified it based on the understanding that the Medicaid population differs from the Medicare population...
November 21, 2017: Population Health Management
https://www.readbyqxmd.com/read/29161406/evaluation-of-the-bacterioscan-216dx-for-standalone-preculture-screen-of-preserved-urine-specimens-in-a-clinical-setting
#2
Amity L Roberts, Upasana Joneja, Tatiana Villatoro, Eileen Andris, Judith A Boyle, James Bondi
Background: The BacterioScan 216Dx laser microbial growth monitoring system was evaluated as an option for preurine culture screening of preserved urine specimens at an acute care medical center. Methods: The BacterioScan 216Dx system performance characteristics and the economic impact (cost effectiveness) for the laboratory were assessed. Urinalysis performance compared to urine culture was assessed if urinalysis was ordered as part of the patient care set. Results: When compared to urine culture, the BacterioScan had an overall performance with corresponding 95% confidence intervals of 76% (68-83) sensitivity, 84% (80-87) specificity, 55% (48-63) positive predictive value, and 93% (90-95) negative predictive value for 610 randomly selected preserved urine specimens...
November 17, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/29161297/prognostic-performance-of-mr-pro-adrenomedullin-in-patients-with-community-acquired-pneumonia-in-the-emergency-department-compared-to-clinical-severity-scores-psi-and-curb
#3
Jacopo Maria Legramante, Maria Mastropasqua, Beniamino Susi, Ottavia Porzio, Marta Mazza, Grazia Miranda Agrippino, Cartesio D Agostini, Antonella Brandi, Germano Giovagnoli, Vito Nicola Di Lecce, Sergio Bernardini, Marilena Minieri
AIM: (i) evaluate the performance of MR-pro-ADM in reflecting the outcome and risk for CAP patients in the emergency department, and (ii) compare the prognostic performance of MR-pro-ADM with that of clinical scores PSI and CURB65. METHODS: Observational prospective, single-center study in patients with suspected community acquired pneumonia (CAP). Eighty one patients underwent full clinical and laboratory assessment as by protocol, and were followed up a 28 days...
2017: PloS One
https://www.readbyqxmd.com/read/29161116/corticosteroid-therapy-for-critically-ill-patients-with-the-middle-east-respiratory-syndrome
#4
Yaseen M Arabi, Yasser Mandourah, Fahad Al-Hameed, Anees A Sindi, Ghaleb A Al Mekhlafi, Mohamed A Hussein, Jesna Jose, Ruxandra Pinto, Awad Al-Omari, Ayman Kharaba, Abdullah Almotairi, Kasim Al Khatib, Basem Alraddadi, Sarah Shalhoub, Ahmed Abdulmomen, Ismael Qushmaq, Ahmed Mady, Othman Solaiman, Abdulsalam M Al-Aithan, Rajaa Al-Raddadi, Ahmed Ragab, Hanan H Balkhy, Abdulrahman Al Harthy, Ahmad M Deeb, Hanan Al Mutairi, Abdulaziz Al-Dawood, Laura Merson, Frederick G Hayden, Robert A Fowler
RATIONALE: Corticosteroid therapy is commonly used among critically ill patients with the Middle East Respiratory Syndrome (MERS), but its impact on outcomes is uncertain. Analyses of observational studies often do not account for patients' clinical condition at the time of corticosteroid therapy initiation. OBJECTIVES: To investigate the association of corticosteroid therapy on mortality and on MERS coronavirus RNA clearance in critically ill patients with MERS...
November 21, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/29160965/current-state-of-practice-transportation-for-patients-with-end-stage-renal-disease
#5
Seri Park, Tamara M Kear
Patients receiving care for the management of end stage renal disease require transport to nephrology practice settings and treatment centers for hemodialysis and peritoneal dialysis. This type of transportation, defined as non-emergency medical transportation, has long presented a challenge for patients, families, and healthcare providers. This article explores the current and projected statistics and trends for chronic kidney disease,transportation challenges faced by patients and nephrology healthcare providers, and examples of successful transportation services and programs...
July 2017: Nephrology Nursing Journal: Journal of the American Nephrology Nurses' Association
https://www.readbyqxmd.com/read/29160511/the-importance-of-audiometric-monitoring-in-patients-with-multidrug-resistant-tuberculosis
#6
Karla Anacleto de Vasconcelos, Silvana Maria Monte Coelho Frota, Antonio Ruffino-Netto, Afrânio Lineu Kritski
INTRODUCTION: A total of 771 cases of multidrug-resistant tuberculosis (MDR-TB) were reported in Brazil in 2014. Treatment of MDR-TB with aminoglycosides can produce serious side effects such as permanent and irreversible hearing loss, which occurs in 5-64% of cases, and severely compromise patient quality of life. The goal of this research was to evaluate auditory and vestibular side effects in patients treated for MDR-TB and to identify associations between these complaints and the type of aminoglycoside used...
September 2017: Revista da Sociedade Brasileira de Medicina Tropical
https://www.readbyqxmd.com/read/29160471/family-interview-guide-strategy-to-develop-skills-in-novice-nurses
#7
Larissa Guanaes Dos Santos, Andréia Cascaes Cruz, Francine Fernandes Pires Mekitarian, Margareth Angelo
OBJECTIVE: describe the skills of nurses to conduct family interviews based on the Family Care Guide for Nursing Clinical Practice. METHOD: exploratory case study that analyzed the content of 16 guides applied to a child emergency service by a novice nurse from the family nursing area. RESULTS: the records indicated the presence of perceptual, conceptual, and executive skills required to conduct family interviews, in particular skills for the development of genograms, therapeutic relationships, and actions to fulfill family needs...
November 2017: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/29160380/frequency-of-copd-in-health-care-workers-who-smoke
#8
Ivan Kopitovic, Aleksandar Bokan, Ilija Andrijevic, Miroslav Ilic, Sanja Marinkovic, Dragana Milicic, Marija Vukoja
OBJECTIVE: COPD is one of the major causes of morbidity and mortality worldwide. Health care providers should counsel their smoking patients with COPD to quit smoking as the first treatment step. However, in countries with high prevalences of smoking, health care workers may also be smokers. The aim of this study was to determine the frequency and severity of COPD in health care workers who smoke. METHODS: This was a cross-sectional study. All health care workers who smoke, from nine health care centers in Serbia, were invited to participate in the study and perform spirometry...
September 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/29160180/incidental-findings-on-fdg-pet-ct-in-head-and-neck-cancer
#9
Christopher J Britt, Austin M Maas, Tabassum A Kennedy, Gregory K Hartig
Objective 18F-fluoro-deoxy-glucose positron emission tomography/computed tomography (FDG PET/CT) imaging is common in head and neck cancer and often identifies incidental findings that necessitate additional patient evaluations. Our goal was to assess the frequency and nature of these incidental imaging findings on FDG-PET/CT. Study Design Retrospective cohort study. Setting Tertiary medical center. Subjects and Methods All patients with head and neck cancer who had undergone FDG-PET/CT imaging between January 2014 and June 2015 at our institution were evaluated for incidental findings...
November 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29160153/voice-and-swallowing-dysfunction-in-neurofibromatosis-2
#10
Simon R Best, Julie Ahn, Shannon Langmead, Vaninder Dhillon, Alexander T Hillel, Lee M Akst, Jaishri O Blakeley
Objective Neurofibromatosis 2 (NF2) is a neuro-oncologic condition that presents with bilateral vestibular schwannomas of the cerebellopontine angle (CPA). Voice and swallowing impairment can occur from direct involvement or compression of the vagus nerve or as the result of surgical excision of CPA tumors. The objectives in this study are to (1) assess the prevalence of voice and swallowing impairments and (2) analyze the effects of vagal dysfunction in patients with NF2. Study Design Cross-sectional. Setting Academic tertiary care center...
November 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29160109/editorial-comment-on-end-2017-0618-or-r1
#11
Mordechai Duvdevani
Percutaneous nephrolithotomy (PCNL) is currently the treatment of choice for large and complex renal calculi. One of the main advantages of PCNL is gaining a real stone-free status in a single session. However, there are several major complications that necessitate careful patient selection for this surgery (1). In this well written manuscript the authors deal with the true rates and importance of residual fragments following PCNL surgeries done in a high volume center. They reviewed 658 PCNL procedures from 2008-2013 that underwent a CT scan on post-operative day one...
November 21, 2017: Journal of Endourology
https://www.readbyqxmd.com/read/29160002/a-randomized-double-blind-trial-of-needle-free-injected-lidocaine-versus-topical-anesthesia-for-infant-lumbar-puncture
#12
Ryan Caltagirone, Vidya R Raghavan, Kathleen Adelgais, Genie E Roosevelt
OBJECTIVES: Lumbar punctures (LPs) are commonly performed in febrile infants to evaluate for meningitis, and local anesthesia increases the likelihood of LP success. Traditional methods of local anesthesia require injection which may be painful or topical application which is not effective immediately. Recent advances in needle-free jet injection may offer a rapid alternative to these modalities. We compared a needle-free jet-injection system (J-Tip(™) ) with 1% buffered lidocaine to topical anesthetic (TA) cream for local anesthesia in infant LPs...
November 20, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29159996/demographic-characteristics-of-teenage-boys-with-horizontal-striae-distensae-of-the-lower-back
#13
Emily Boozalis, Anna L Grossberg, Katherine B Puttgen, Candrice R Heath, Bernard A Cohen
BACKGROUND: This study examines the clinical characteristics and demographics of teenage boys with horizontal striae distensae of the lower back in an outpatient setting. METHODS: Retrospective medical chart reviews and telephone survey studies were completed on an outpatient cohort of 12 boys 11 to 17 years of age with a clinical diagnosis of transverse striae distensae of the lower back at a single-center, university-based, pediatric dermatology practice. We evaluated the clinical features of the striae, participant demographic characteristics, and past medical history...
November 21, 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/29159958/evaluation-of-a-low-risk-mild-traumatic-brain-injury-and-intracranial-hemorrhage-emergency-department-observation-protocol
#14
Brian J Yun, Pierre Borczuk, Lulu Wang, Stephen Dorner, Benjamin A White, Ali S Raja
OBJECTIVES: Among emergency physicians, there is wide variation in admitting practices for patients who suffered a mild traumatic brain injury (TBI) with an intracranial hemorrhage (ICH). The purpose of this study was to evaluate the effects of implementing a protocol in the emergency department (ED) observation unit for patients with mild TBI and ICH. METHODS: This retrospective cohort study was approved by the Institutional Review Board. Study subjects were patients ≥18 years of age with an International Classification of Diseases (ICD) code corresponding to a traumatic IC, and admitted to an ED observation unit (EDOU) of an urban, academic level 1 trauma center between February 1, 2015 and January 31, 2017...
November 20, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29159943/retrospective-multicenter-study-of-leaving-the-placenta-in-situ-for-patients-with-placenta-previa-on-a-cesarean-scar
#15
Kei Miyakoshi, Toshimitsu Otani, Eiji Kondoh, Shintaro Makino, Mamoru Tanaka, Satoru Takeda
OBJECTIVE: To investigate maternal outcomes after leaving the placenta in situ for placenta accreta spectrum (PAS) disorders in patients with placenta previa on a cesarean delivery scar. METHODS: The present retrospective study reviewed medical records from women with placenta previa on a cesarean scar underwent perinatal care at secondary- or tertiary-level perinatal centers in Japan between January 1, 2010, and December 31, 2014. Perinatal management was conducted based on each leading obstetrician's discretion...
November 21, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/29159931/targets-and-teamwork-understanding-differences-in-pediatric-diabetes-centers-treatment-outcomes
#16
Timothy C Skinner, Karin S Lange, Hilary Hoey, Henrik B Mortensen, Henk-Jan Aanstoot, Luis Castaňo, Soren Skovlund, Peter Gf Swift, Fergus J Cameron, Harry R Dorchy, Mark R Palmert, Eero Kaprio, Jean-Jacques Robert, Thomas Danne, Andreas Neu, Shlomit Shalitin, Francesco Chiarelli, Giovanni Chiari, Tatsuhiko Urakami, Pål R Njølstad, Premyslawa K Jarosz-Chobot, Edna F Roche, Cintia G Castro-Correia, Mirjana Kocova, Jan Åman, Eugen Schönle, Timothy G Barrett, Lynda Fisher, Carine E de Beaufort
OBJECTIVE: The reason for center differences in metabolic control of childhood diabetes is still unknown. We sought to determine to what extent the targets, expectations, and goals that diabetes care professionals have for their patients is a determinant of center differences in metabolic outcomes. RESEARCH DESIGN AND METHODS: Children, under the age of 11 with type 1 diabetes and their parents treated at the study centers participated. Clinical, medical, and demographic data were obtained, along with blood sample for centralized assay...
November 20, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/29159733/management-of-hemophilia-in-older-patients
#17
REVIEW
Massimo Franchini, Pier Mannuccio Mannucci
In recent decades, several improvements in hemophilia care have resulted in increased quality of life and life expectancy for those affected by this inherited hemorrhagic condition. Nowadays, individuals with hemophilia enjoy a life expectancy at birth close to that of males in the general population. As a consequence of the increasing age of the hemophilia population, a growing number of these patients develop age-related co-morbidities, such as cardiovascular disease and cancer, the management of which represents a new challenge for caregivers at hemophilia treatment centers...
November 20, 2017: Drugs & Aging
https://www.readbyqxmd.com/read/29159719/effect-of-a-real-time-electronic-dashboard-on-a-rapid-response-system
#18
Grant S Fletcher, Barry A Aaronson, Andrew A White, Reena Julka
A rapid response system (RRS) may have limited effectiveness when inpatient providers fail to recognize signs of early patient decompensation. We evaluated the impact of an electronic medical record (EMR)-based alerting dashboard on outcomes associated with RRS activation. We used a repeated treatment study in which the dashboard display was successively turned on and off each week for ten 2-week cycles over a 20-week period on the inpatient acute care wards of an academic medical center. The Rapid Response Team (RRT) dashboard displayed all hospital patients in a single view ranked by severity score, updated in real time...
November 20, 2017: Journal of Medical Systems
https://www.readbyqxmd.com/read/29159605/outcomes-of-emergency-laparotomy-el-care-protocol-at-tertiary-care-center-from-low-middle-income-country-lmic
#19
Nitin Vashistha, Dinesh Singhal, Sandeep Budhiraja, Bharat Aggarwal, Raj Tobin, Kamal Fotedar
BACKGROUND: Emergency laparotomy mortality ranges between 10 and 20% in best of Western healthcare systems and is currently a major focus for quality improvement programs. In contrast, emergency surgery scenario in LMIC is largely undefined, often neglected and complex (large burden of diseases but only limited capacity for adequate treatment). We evaluated the efficacy of 'EL care protocol' aimed at cost-effective optimal utilization of best available local expertise and infrastructure...
November 20, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29159555/use-of-a-hands-free-instantaneous-closed-loop-communication-device-improves-perception-of-communication-and-workflow-integration-in-an-academic-teaching-hospital-a-pilot-study
#20
Daniel Z Fang, Teja Patil, Ilana Belitskaya-Levy, Marianne Yeung, Keith Posley, Nazima Allaudeen
Efficient and effective communication between providers is critical to quality patient care within a hospital system. Hands free communication devices (HFCD) allow instantaneous, closed-loop communication between physicians and other members of a multidisciplinary team, providing a communication advantage over traditional pager systems. HFCD have been shown to decrease emergency room interruptions, improve nursing communication, improve speed of information flow, and eliminate health care waste. We evaluated the integration of an HFCD with an existing alphanumeric paging system on an acute inpatient medicine service...
November 17, 2017: Journal of Medical Systems
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