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https://www.readbyqxmd.com/read/30314929/lung-ultrasound-for-the-emergency-diagnosis-of-pneumonia-acute-heart-failure-and-exacerbations-of-chronic-obstructive-pulmonary-disease-asthma-in-adults-a-systematic-review-and-meta-analysis
#1
Leonardo Jönck Staub, Roberta Rodolfo Mazzali Biscaro, Erikson Kaszubowski, Rosemeri Maurici
BACKGROUND: Lung ultrasound can accelerate the diagnosis of life-threatening diseases in adults with respiratory symptoms. OBJECTIVE: Systematically review the accuracy of lung ultrasonography (LUS) for emergency diagnosis of pneumonia, acute heart failure, and exacerbation of chronic obstructive pulmonary disease (COPD)/asthma in adults. METHODS: PubMed, Embase, Scopus, Web of Science, and LILACS (Literatura Latino Americana e do Caribe em Ciências da Saúde; until 2016) were searched for prospective diagnostic accuracy studies...
October 9, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/30314827/recognition-and-treatment-of-sleep-disordered-breathing-in-obese-african-american-hospitalized-patients-may-improve-outcome
#2
Abigail Quintos, Mario Naranjo, Colleen Kelly, Stuart F Quan, Sunil Sharma
PURPOSE: The HoSMed Database recently demonstrated a high prevalence of obstructive sleep apnea (OSA) in hospitalized obese patients. Based on a long-term follow-up, this study showed an improved survival among patients who were adherent with the therapy. In this post-hoc analysis we explore the characteristics, associations, and mortality outcome of OSA in the African American (AA) population. METHODS: These subset analyses included obese AA patients screened in the hospital as high-risk for OSA...
October 9, 2018: Journal of the National Medical Association
https://www.readbyqxmd.com/read/30312893/multicomorbidity-of-chronic-diseases-and-substance-use-disorders-and-their-association-with-hospitalization-results-from-electronic-health-records-data
#3
Li-Tzy Wu, He Zhu, Udi E Ghitza
BACKGROUND: Chronic diseases are prevalent and the leading causes of mortality. Comorbidity of substance use disorders (SUDs) and chronic diseases is understudied to inform behavioral healthcare integration. OBJECTIVES: This study leveraged electronic health record (EHR) data of 211,880 adults from a large health system to examine prevalence and correlates of comorbidity of SUDs and nine chronic disease groups and to determine their association with hospitalization...
October 2, 2018: Drug and Alcohol Dependence
https://www.readbyqxmd.com/read/30307708/right-heart-failure-as-a-risk-factor-for-severe-exacerbation-in-patients-with-chronic-obstructive-pulmonary-disease-prospective-cohort-study
#4
A Orea-Tejeda, A Navarrete-Peñaloza, L Verdeja-Vendrell, A Jiménez-Cepeda, D González-Islas, R Hernández-Zenteno, C Keirns-Davis, R Sánchez-Santillán, A Velazquez-Montero, G A Puentes Rodríguez
BACKGROUND: The prognosis in patients with Chronic Obstructive Pulmonary Disease (COPD) depends in large part on the frequency of exacerbations. Cardiovascular diseases, including heart failure (HF), are risk factors for exacerbations. However, its unknown the importance of HF type over the exacerbations in COPD patients. OBJECTIVE: To determine whether right heart failure (RHF) is an independent risk factor for severe exacerbations in patients with COPD. METHODS: A prospective cohort study of 133 patients diagnosed with COPD with a follow-up period from 2010 to 2016...
October 11, 2018: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/30304755/-exercise-testing-in-respiratory-medicine-dgp-recommendations
#5
F J Meyer, M M Borst, H-C Buschmann, M Claussen, D Dumitrescu, R Ewert, B Friedmann-Bette, S Gläser, R Glöckl, K Haring, B Lehnigk, U Ochmann, A M Preisser, S Sorichter, M Westhoff, H Worth
This document replaces the DGP recommendations published in 1998 and 2013. Based on recent studies and a consensus conference, the indications, choice and performance of the adequate exercise testing method and its necessary technical and staffing setting are discussed. Detailed recommendations are provided: for blood gas analysis and right heart catheterization during exercise, walk tests, spiroergometry, and stress echocardiography. The correct use of different exercise tests is discussed for specific situations in respiratory medicine: exercise induced asthma, obesity, monitoring of rehabilitation or therapeutical interventions, preoperative risk stratification, and evaluation in occupational medicine...
October 2018: Pneumologie
https://www.readbyqxmd.com/read/30277217/estonia-health-system-review
#6
Triin Habicht, Marge Reinap, Kaija Kasekamp, Riina Sikkut, Laura Aaben, Ewout van Ginneken
This analysis of the Estonian health system reviews recent developments in organization and governance, health financing, health care provision, health reforms and health system performance. In 2017, the Estonian government took the historic step of expanding the revenue base of the health system, which has been a longstanding challenge. However, in terms of percentage of GDP it remains a small increase and long-term financial sustainability could still pose a problem. That said, if these additional funds are invested wisely, they could play a positive role in further improving the health system...
March 2018: Health Systems in Transition
https://www.readbyqxmd.com/read/30271014/predictors-of-abnormal-electrocardiograms-in-the-pediatric-emergency-department
#7
Shiv Gandhi, Miranda Lin, Sharon R Smith, Jesse J Sturm
Background: Electrocardiograms (ECGs) are ordered in the pediatric emergency room for a wide variety of chief complaints. Objectives: Criteria are lacking as to when physicians should obtain ECGs. This study uses a large retrospective cohort of 880 pediatric emergency department (ED) patients to highlight objective criteria including significant medical history and specific vital sign abnormalities to guide clinicians as to which patients might have an abnormal ECG...
September 2018: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/30262890/targeting-g-protein-coupled-receptor-signalling-by-blocking-g-proteins
#8
REVIEW
Adrian P Campbell, Alan V Smrcka
G protein-coupled receptors (GPCRs) are the largest class of drug targets, largely owing to their druggability, diversity and physiological efficacy. Many drugs selectively target specific subtypes of GPCRs, but high specificity for individual GPCRs may not be desirable in complex multifactorial disease states in which multiple receptors may be involved. One approach is to target G protein subunits rather than the GPCRs directly. This approach has the potential to achieve broad efficacy by blocking pathways shared by multiple GPCRs...
September 28, 2018: Nature Reviews. Drug Discovery
https://www.readbyqxmd.com/read/30261859/mental-and-physical-comorbidity-in-an-arab-primary-health-care-setting
#9
Sulaiman Alkhadhari, Aseel Omran Alsabrrie, Jude Uzoma Ohaeri, Ramani Varghese, Muhammad Ajmal Zahid, Benoit H Mulsant
BACKGROUND: There are no published studies on the comorbidity of common mental conditions (anxiety, depression, and somatization) and physical illnesses in the Arab world. Our aim was to estimate the prevalence of common mental conditions comorbid with physical illnesses among primary care attenders in Kuwait, and the sociodemographic characteristics associated with this comorbidity. METHODS: The Patient Health Questionnaires for somatization, anxiety and depression (PHQ-SAD) were administered to a representative sample of 1046 attenders (M: F = 429: 617; mean age 37...
September 27, 2018: BMC Psychiatry
https://www.readbyqxmd.com/read/30254041/imperative-instruction-for-pressurized-metered-dose-inhalers-provider-perspectives
#10
Daniel C Schmitz, Rebecca A Ivancie, Kyung E Rhee, Heather C Pierce, Alicia O Cantu, Erin S Fisher
BACKGROUND: Reports show that many patients do not use their pressurized metered-dose inhalers (pMDIs) effectively. The National Heart, Lung, and Blood Institute recommends that health-care providers educate and assess patients' pMDI technique at each opportunity. However, limited data exist regarding how often pediatric primary care providers perform assessments and which methods they use. We sought to (1) identify instructional methods used to teach pMDI use, (2) describe how pMDI use is reassessed at follow-up visits, and (3) describe primary care provider attitudes and barriers to in-office pMDI instruction...
September 25, 2018: Respiratory Care
https://www.readbyqxmd.com/read/30233808/exercise-performance-after-salbutamol-inhalation-in-non-asthmatic-non-athlete-individuals-a-randomised-controlled-cross-over-trial
#11
Filip Eckerström, Christian Emil Rex, Marie Maagaard, Sune Rubak, Vibeke Elisabeth Hjortdal, Johan Heiberg
Background: Asthma is a frequent diagnosis in competitive sports, and inhaled β2 -agonists are commonly used by athletes. Although inhaled β2 -agonists do not seem to improve performance in athletes, it has remained uncertain whether they can increase exercise performance in non-athletes. Objective: To investigate the effect of inhaled β2 -agonists on exercise performance in healthy non-athlete individuals. Methods: In a double-blinded, placebo-controlled, cross-over trial, healthy, non-asthmatic, non-athlete individuals were randomised to inhalation of either 900 µg of salbutamol or placebo...
2018: BMJ Open Sport & Exercise Medicine
https://www.readbyqxmd.com/read/30196203/differential-effects-of-size-specific-particulate-matter-on-emergency-department-visits-for-respiratory-and-cardiovascular-diseases-in-guangzhou-china
#12
Erjia Ge, Kefang Lai, Xiong Xiao, Ming Luo, Zhangfu Fang, Yanjun Zeng, Hong Ju, Nanshan Zhong
BACKGROUND: Studies differentiating the cardiorespiratory morbidity effects of PM2.5 , PM10 , and PM2.5∼10 (i.e. coarse PM or PMc) are still limited and inconsistent. OBJECTIVE: To estimate the acute, cumulative, and harvesting effects of exposure to the three size-specific PM on cardiorespiratory morbidity, and their concentration-response relations. METHODS: A total of 6,727,439 emergency department (ED) visits were collected from 16 public teaching hospitals in Guangzhou, from January 1st 2012 to December 31st 2015, among which over 2...
December 2018: Environmental Pollution
https://www.readbyqxmd.com/read/30195374/a-47-year-old-man-with-progressive-mental-deterioration-during-ventilator-management-of-asthma-in-the-icu
#13
Izumi Nakayama, Junichi Izawa, Shin Yamashiro, Tomoo Kishaba
A 47-year-old man was admitted to the ICU with acute hypercapnic respiratory failure caused by a severe asthma attack. He had a history of asthma, atrial septal defect, chronic heart failure, and atrial fibrillation. He underwent surgical closure of the atrial septal defect at 7 years of age and was asymptomatic until 38 years of age when he developed congestive heart failure because of structural cardiac abnormalities, including left ventricular systolic dysfunction, biatrial enlargement, and mild mitral and tricuspid regurgitation...
September 2018: Chest
https://www.readbyqxmd.com/read/30177479/obesity-and-loss-of-disease-free-years-owing-to-major-non-communicable-diseases-a-multicohort-study
#14
Solja T Nyberg, G David Batty, Jaana Pentti, Marianna Virtanen, Lars Alfredsson, Eleonor I Fransson, Marcel Goldberg, Katriina Heikkilä, Markus Jokela, Anders Knutsson, Markku Koskenvuo, Tea Lallukka, Constanze Leineweber, Joni V Lindbohm, Ida E H Madsen, Linda L Magnusson Hanson, Maria Nordin, Tuula Oksanen, Olli Pietiläinen, Ossi Rahkonen, Reiner Rugulies, Martin J Shipley, Sari Stenholm, Sakari Suominen, Töres Theorell, Jussi Vahtera, Peter J M Westerholm, Hugo Westerlund, Marie Zins, Mark Hamer, Archana Singh-Manoux, Joshua A Bell, Jane E Ferrie, Mika Kivimäki
BACKGROUND: Obesity increases the risk of several chronic diseases, but the extent to which the obesity-related loss of disease-free years varies by lifestyle category and across socioeconomic groups is unclear. We estimated the number of years free from major non-communicable diseases in adults who are overweight and obese, compared with those who are normal weight. METHODS: We pooled individual-level data on body-mass index (BMI) and non-communicable diseases from men and women with no initial evidence of these diseases in European cohort studies from the Individual-Participant-Data Meta-Analysis in Working Populations consortium...
October 2018: Lancet. Public Health
https://www.readbyqxmd.com/read/30176068/allergies-and-autoimmune-disorders-in-children-after-heart-transplantation
#15
Nicholas Avdimiretz, Stefanie Seitz, Tiffany Kim, Faye Murdoch, Simon Urschel
Pediatric heart transplantation requires lifelong immune suppression and may require thymectomy, both of which alter T-cell repertoires. We hypothesized that atopic and autoimmune diseases are more common in pediatric heart transplant patients than the general population, and that transplantation in early childhood increases the risk of development or worsening of atopic or autoimmune disease. A cross-sectional single-center study including 21 heart transplant patients aged ≤18 years was conducted. Data collected included age at transplant, induction, thymectomy, and development and severity of atopic or autoimmune disease...
September 3, 2018: Clinical Transplantation
https://www.readbyqxmd.com/read/30175734/nasopharyngeal-carriage-prevalence-serotype-distribution-and-antimicrobial-resistance-of-streptococcus-pneumoniae-among-children-with-chronic-diseases
#16
Serdar Pekuz, Ahmet Soysal, Gulsen Akkoc, Serkan Atıcı, Nurhayat Yakut, Gulsen Altınkanat Gelmez, Eda Kepenekli Kadayifci, Deniz Güneser, Sevliya Ocal Demir, Guner Söyletir, Mustafa Bakır
The aim of this study is to evaluate the nasopharyngeal (NP) carriage prevalence, serotype distribution and antimicrobial resistance of Streptococcus pneumoniae (SP) in children with chronic diseases that predispose them to invasive pneumococcal disease (IPD) in comparison with healthy children.A cross sectional prevalence study was performed between February 2015 and February 2016 in Istanbul, Turkey. We enrolled 1024 children with chronic diseases and 394 healthy children aged 0-18 years.Overall prevalence of SPNP carriage was 9...
August 31, 2018: Japanese Journal of Infectious Diseases
https://www.readbyqxmd.com/read/30171678/incremental-health-care-costs-associated-with-food-insecurity-and-chronic-conditions-among-older-adults
#17
Sandra P Garcia, Anne Haddix, Kevin Barnett
INTRODUCTION: The prevalence of food insecurity and chronic health conditions among older adults is a public health concern. However, little is known about associated health care costs. We estimated the incremental health care costs of food insecurity and selected chronic health conditions among older adults, defined as adults aged 50 or older. METHODS: We analyzed 4 years of data (2011-2014) from the National Health Interview Survey and 3 years of data (2013-2015) from the Medical Expenditure Panel Survey; we used 2-part models to estimate the incremental health care costs associated with food insecurity and 9 chronic conditions (hypertension, coronary heart disease, stroke, emphysema, asthma, cancer, chronic bronchitis, arthritis, and diabetes) among older adults...
August 30, 2018: Preventing Chronic Disease
https://www.readbyqxmd.com/read/30169464/epidemiology-of-patients-presenting-with-dyspnea-to-emergency-departments-in-europe-and-the-asia-pacific-region
#18
Said Laribi, Gerben Keijzers, Oene van Meer, Sharon Klim, Justina Motiejunaite, Win Sen Kuan, Richard Body, Peter Jones, Mehmet Karamercan, Simon Craig, Veli-Pekka Harjola, Anna Holdgate, Adela Golea, Colin Graham, Franck Verschuren, Jean Capsec, Michael Christ, Leslie Grammatico-Guillon, Cinzia Barletta, Luis Garcia-Castrillo, Anne-Maree Kelly
OBJECTIVE: The primary objective of this study was to describe the epidemiology and management of dyspneic patients presenting to emergency departments (EDs) in an international patient population. Our secondary objective was to compare the EURODEM and AANZDEM patient populations. PATIENTS AND METHODS: An observational prospective cohort study was carried out in Europe and the Asia-Pacific region. The study included consecutive patients presenting to EDs with dyspnea as the main complaint...
August 30, 2018: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/30157939/effect-of-maternal-mental-health-improvement-programs-on-obesity-in-pediatric-populations-a-protocol-for-a-systematic-review-and-meta-analysis
#19
Abdul Wajid, Muhammad Kashif Mughal, Deborah McNeil, Helen Lee Robertson, Dawn Kingston
BACKGROUND: Childhood obesity has become a global epidemic irrespective of the socioeconomic status of a country or nation. Obesity increases the risk of various diseases in children, for example asthma, sleep apnea, bone and joint problems, type-2 diabetes, and heart problems. The existing literature informs us of the many factors associated with childhood obesity. Among these factors, maternal mental health has been found to be a strong predictor. Maternal mental health programs were implemented to address the issue of childhood obesity but with little or no improvement...
August 29, 2018: Systematic Reviews
https://www.readbyqxmd.com/read/30130029/impact-of-a-medical-home-model-on-costs-and-utilization-among-comorbid-hiv-positive-medicaid-patients
#20
Paul Crits-Christoph, Robert Gallop, Elizabeth Noll, Aileen Rothbard, Caroline K Diehl, Mary Beth Connolly Gibbons, Robert Gross, Karin V Rhodes
OBJECTIVES: The Pennsylvania Chronic Care Initiative (CCI) was a statewide patient-centered medical home (PCMH) initiative implemented from 2008 to 2011. This study examined whether the CCI affected utilization and costs for HIV-positive Medicaid patients with both medical and behavioral health comorbidities. STUDY DESIGN: Nonrandomized comparison of 302 HIV-positive Medicaid patients treated in 137 CCI practices and 2577 HIV-positive Medicaid patients treated elsewhere...
August 2018: American Journal of Managed Care
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