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Pietro Muratori, Annarita Milone, Valentina Levantini, Laura Ruglioni, Furio Lambruschi, Simone Pisano, Gabriele Masi, John E Lochman
Children with severe aggressive behavioral problems are one of the groups most frequently referred to mental health clinics, and they engage in behaviors that put them at risk for substance use problems and a host of other negative outcomes. The present study aimed to assess the long-term outcome (six-year follow up) of the Coping Power Program delivered in a mental health hospital for children with behavioral disorders. We recruited one hundred and twenty children (mean age = 9.9, SD = 0.85), twenty-three patients were lost during the follow-ups...
December 4, 2018: Psychiatry Research
Mitsuru Yagi, Naobumi Hosogane, Nobuyuki Fujita, Eijiro Okada, Satoshi Suzuki, Osahiko Tsuji, Narihito Nagoshi, Takashi Asazuma, Takashi Tsuji, Masaya Nakamura, Morio Matsumoto, Kota Watanabe
BACKGROUND CONTEXT: Corrective surgery for adult spinal deformity (ASD) improves health-related quality of life but has high complication rates. Predicting a patient's risk of perioperative and late postoperative complications is difficult, although several potential risk factors have been reported. PURPOSE: To establish an accurate, ASD-specific model for predicting the risk of postoperative complications, based on baseline demographic, radiographic, and surgical invasiveness data in a retrospective case series...
December 8, 2018: Spine Journal: Official Journal of the North American Spine Society
Daniel B Chastain, Anthony Davis
Osteomyelitis remains difficult to treat, typically requiring a prolonged course of intravenous (IV) antibiotics. The optimal route and duration of antibiotics remains ill-defined due to limited prospective clinical trials. Oritavancin is a long acting, semisynthetic, lipoglycopeptide antibiotic with rapid, concentration-dependent bactericidal activity against many Gram-positive organisms. Favorable pharmacokinetics makes oritavancin an appealing alternative for currently available antibiotics requiring daily infusions to decrease the risk of vascular access complications associated with outpatient antimicrobial therapy...
December 8, 2018: International Journal of Antimicrobial Agents
Francesca Marino, Luca Nunziata
Policy Points Policymakers should invest more on researching the long-term health effects of low-ionizing radiation exposure, as we are far from reaching a consensus on a topic that is of enormous importance for public health and safety. Public policies such as those limiting the import of contaminated food from areas hit by a radioactive disaster or those regulating the resident population's access to such areas should follow a precautionary approach. Neoplasm diagnosis and medical care should be designed in order to take into account the possible role of long-term, low-dose radiation exposure...
December 2018: Milbank Quarterly
Jacques Bouget, Frédéric Balusson, Lucie-Marie Scailteux, Maxime Maignan, Pierre-Marie Roy, Erwan L'her, Laure Pavageau, Emmanuel Nowak
Bleeding represents the most recognised and feared complications of antithrombotic drugs including oral anticoagulants. Previous studies showed inconsistent results on the safety profile. Among explanations, bleeding definition could vary and classification bias exist related to the lack of medical evaluation. To quantify the risk of major haemorrhagic event and event-free survival associated with antithrombotic drugs (Vitamin K Antagonist [VKA], non-VKA anticoagulant [NOAC], antiplatelet agent, parenteral anticoagulant) in 2012-2015, we linked the French nationwide Health Insurance database (SNIIRAM) with a local "emergency database" (clinical and biological data collected in clinical records)...
December 10, 2018: Fundamental & Clinical Pharmacology
Jae H Kang, Julie P W Bynum, Lu Zhang, Francine Grodstein, David G Stevenson
BACKGROUND/OBJECTIVES: Relatively little is known regarding predictors of advance care planning (ACP) in former nurses. We aimed to evaluate potential predictors of ACP documentation and discussion. DESIGN: Cross-sectional study, 2012-2014. SETTING: Nurses' Health Study. PARTICIPANTS: A total of 60,917 community-dwelling female nurses aged 66 to 93 years living across the United States. MEASUREMENTS: Based on self-reports, participants were categorized as having (1) only ACP documentation, (2) ACP documentation and a recent ACP discussion with a healthcare provider, or (3) neither...
December 10, 2018: Journal of the American Geriatrics Society
Cristiane da Mata, Patrick Finbar Allen, Gerald John McKenna, Martina Hayes, Ali Kashan
OBJECTIVE: To assess the oral-health-related quality of life (OHRQoL) in a cohort of Irish older patients and explore associations with overall health status. BACKGROUND: The impact of oral health conditions on older individuals' quality of life may be influenced by patients' general health status. MATERIALS AND METHODS: This paper reports a cross-sectional study, which analysed baseline data from patients aged over 60 years. Patients were recruited from two different environments, namely Cork University Dental Hospital and St...
December 7, 2018: Gerodontology
Pauline Joyce, Zena Eh Moore, Janice Christie
BACKGROUND: Pressure ulcers, which are a localised injury to the skin, or underlying tissue, or both, occur when people are unable to reposition themselves to relieve pressure on bony prominences. Pressure ulcers are often difficult to heal, painful, expensive to manage and have a negative impact on quality of life. While individual patient safety and quality care stem largely from direct healthcare practitioner-patient interactions, each practitioner-patient wound-care contact may be constrained or enhanced by healthcare organisation of services...
December 9, 2018: Cochrane Database of Systematic Reviews
Johanna E Bellon, Andrew Bilderback, Namita S Ahuja-Yende, Cindy Wilson, Stefanie C Altieri Dunn, Deborah Brodine, Michael L Boninger
OBJECTIVES: To compare rates of 30- and 90-day hospital readmissions and observation or emergency department (ED) returns of older adults using the University of Pittsburgh Medical Center (UPMC) Health Plan Home Transitions (HT) with those of Medicare fee-for-service (FFS) controls without HT. DESIGN: Retrospective cohort study. SETTING: Analysis of home health and hospital records from 8 UPMC hospitals in Allegheny County, Pennsylvania, from July 1, 2015, to April 30, 2017...
December 8, 2018: Journal of the American Geriatrics Society
Janani Pinidiyapathirage, Scott Kitchener, Sarah McNamee, Sacha Wynter, Jack Langford, Ashley Doyle, Andrew McMahon
OBJECTIVE: Agricultural industries are among the most dangerous in Australia posing significant public health risks. This study analyses the nature and management of agriculture-related injuries presenting to EDs in selected hospitals in Southern Queensland. METHODS: Data on agricultural injury presentations over a 6 month period was collected at four rural hospitals by a dedicated onsite hospital data coordinator. Additionally, in two of the participating hospitals all injury presentations over the same 6 month period were recorded...
December 11, 2018: Emergency Medicine Australasia: EMA
Pooja Dewan, Pardeep S Jhund, Li Shen, Mark C Petrie, William T Abraham, M Atif Ali, Chen-Huan Chen, Akshay S Desai, Kenneth Dickstein, Jun Huang, Songsak Kiatchoosakun, Kee-Sik Kim, Lars Køber, Wen-Ter Lai, Yuhua Liao, Ulrik M Mogensen, Byung-Hee Oh, Milton Packer, Jean L Rouleau, Victor Shi, Antonio S Sibulo, Scott D Solomon, Piyamitr Sritara, Karl Swedberg, Hiroyuki Tsutsui, Michael R Zile, John J V McMurray
AIMS: Nearly 60% of the world's population lives in Asia but little is known about the characteristics and outcomes of Asian patients with heart failure with reduced ejection fraction (HFrEF) compared to other areas of the world. METHODS AND RESULTS: We pooled two, large, global trials, with similar design, in 13 174 patients with HFrEF (patient distribution: China 833, India 1390, Japan 209, Korea 223, Philippines 223, Taiwan 199 and Thailand 95, Western Europe 3521, Eastern Europe 4758, North America 613, and Latin America 1110)...
December 10, 2018: European Journal of Heart Failure
Han Ni, Soe Moe, Zay Soe, Kay Thi Myint, K Neelakantan Viswanathan
BACKGROUND: Several dual bronchodilator combinations of long-acting beta2 -agonist (LABA) and long-acting muscarinic antagonist (LAMA) have been approved for treatment of stable chronic obstructive pulmonary disease (COPD). The current GOLD (Global Initiative for Chronic Obstructive Lung Disease) recommendations suggest the use of LABA/LAMA combinations in people with group B COPD with persistent symptoms, group C COPD with further exacerbations on LAMA therapy alone and group D COPD with or without inhaled corticosteroids (ICS)...
December 11, 2018: Cochrane Database of Systematic Reviews
Daisuke Minakata, Shin-Ichiro Fujiwara, Takashi Ikeda, Shin-Ichiro Kawaguchi, Yumiko Toda, Shoko Ito, Shin-Ichi Ochi, Takashi Nagayama, Kiyomi Mashima, Kento Umino, Hirofumi Nakano, Ryoko Yamasaki, Kaoru Morita, Yasufumi Kawasaki, Miyuki Sugimoto, Chihiro Yamamoto, Masahiro Ashizawa, Kaoru Hatano, Kazuya Sato, Iekuni Oh, Ken Ohmine, Kazuo Muroi, Tsukasa Ohmori, Yoshinobu Kanda
We evaluated clinical outcomes of disseminated intravascular coagulation (DIC) in patients with hematological malignancies treated with synthetic protease inhibitors (SPIs) and compared the effects of gabexate mesilate (FOY) and nafamostat mesilate (FUT). We retrospectively examined 127 patients [acute myeloid leukemia (n = 48), acute lymphoblastic leukemia (n = 25), and non-Hodgkin lymphoma (n = 54)] with DIC, who were diagnosed according to Japanese Ministry of Health, Labour and Welfare criteria and treated with SPIs [FOY (n = 55) and FUT (n = 72)] at our hospital from 2006 to 2015...
December 8, 2018: International Journal of Hematology
Mohammed Aradaib, Paul Neary, Adnan Hafeez, Reza Kalbassi, Amjad Parvaiz, Diarmuid O'Riordain
Robotic surgery enhances the precision of minimally invasive surgery through improved three-dimensional views and articulated instruments. There has been increasing interest in adopting this technology to colorectal surgery and this has recently been introduced to the Irish health system. This paper gives an account of our early institutional experience with adoption of robotic colorectal surgery using structured training. Analysis was conducted of a prospectively maintained database of our first 55 consecutive robotic colorectal cases, performed by four colorectal surgeons, each at the beginning of his robotic surgery experience, using the Da Vinci Si® system and undergoing training as per the European Academy of Robotic Colorectal Surgery (EARCS) programme...
December 10, 2018: Journal of Robotic Surgery
Melissa A LoPresti, I-Wen Pan, Nisha Gadgil, Kathryn Wagner, Sandi Lam
INTRODUCTION: Chiari malformation type 1 (CM-1) is a common congenital or acquired malformation of the posterior fossa. We aimed to characterize preoperative risk factors, perioperative complications, and postoperative outcomes related to CM-1 surgery in pediatric populations across a nationwide network of pediatric hospitals in the United States (US). METHODS: The Children's Hospital Association's Pediatric Health Information System (PHIS) database was used to examine patients < 21 years old in the US-based nationwide database who underwent inpatient surgery for CM-1 from 2007 to 2015...
December 10, 2018: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Walaa F Abdelmoaty, Christy M Dunst, Chris Neighorn, Lee L Swanstrom, Chet W Hammill
BACKGROUND: Cost-effectiveness of robotic-assisted surgery is still debatable. Robotic-assisted inguinal hernia repair has no clear clinical benefit over laparoscopic repair. We performed a comprehensive cost-analysis comparison between the two approaches for evaluation of their cost-effectiveness in a large healthcare system in the Western United States. METHODS: Health records in 32 hospitals were queried for procedural costs of inguinal hernia repairs between January 2015 and March 2017...
December 7, 2018: Surgical Endoscopy
Carlos Toufen Junior, Roberta R De Santis Santiago, Adriana S Hirota, Alysson Roncally S Carvalho, Susimeire Gomes, Marcelo Brito Passos Amato, Carlos Roberto Ribeiro Carvalho
BACKGROUND: Acute respiratory distress syndrome (ARDS) patients may present impaired in lung function and structure after hospital discharge that may be related to mechanical ventilation strategy. The aim of this study was to evaluate the association between functional and structural lung impairment, N-terminal-peptide type III procollagen (NT-PCP-III) and driving pressure during protective mechanical ventilation. It was a secondary analysis of data from randomized controlled trial that included patients with moderate/severe ARDS with at least one follow-up visit performed...
December 7, 2018: Annals of Intensive Care
Nader Najafi, Russ Cucina, Bruce Pierre, Raman Khanna
Importance: Physicians frequently use cardiac monitoring, or telemetry, beyond the duration recommended by published practice standards, resulting in "alarm fatigue" and excess cost. Prior studies have demonstrated an association between multicomponent quality improvement interventions and safe reduction of telemetry duration. Objective: To determine if a single-component intervention, a targeted electronic health record (EHR) alert, could achieve similar gains to multicomponent interventions and safely reduce unnecessary monitoring...
December 10, 2018: JAMA Internal Medicine
William B Weeks, Alan N West
No abstract text is available yet for this article.
December 11, 2018: Annals of Internal Medicine
Katherine Ni, Binhuan Wang, Alissa Link, Scott Sherman
Introduction: Though many interventions have been shown to be effective in helping smokers quit, outcomes may differ between light and heavy smokers. We identified differences in baseline characteristics and post-intervention cessation rates among smoker groups at two safety-net hospitals. Methods: We retrospectively analyzed cessation rates in 1,604 patients randomized to either a quitline referral (1-2 telephone counseling sessions) or intensive counseling program (7 telephone sessions)...
December 11, 2018: Nicotine & Tobacco Research: Official Journal of the Society for Research on Nicotine and Tobacco
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