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https://www.readbyqxmd.com/read/28736059/anti-factor-xa-measurements-in-acute-care-surgery-patients-to-examine-enoxaparin-dose
#1
Vanessa Wall, Kory I Fleming, Joseph E Tonna, Jade Nunez, Nick Lonardo, R Wayne Shipley, Ram Nirula, Christopher J Pannucci
BACKGROUND: The purpose of this study was to determine if fixed dose enoxaparin prophylaxis provided effective anticoagulation for acute care surgery patients and to examine whether a real-time enoxaparin dose adjustment algorithm optimized anticoagulation. METHODS: Acute care surgical patients placed on enoxaparin prophylaxis 30 mg twice daily were recruited prospectively. Peak steady state aFXa levels were drawn with a goal peak aFXa range of 0.2-0.4 IU/ml. A real time dose adjustment algorithm was implemented for patients with out-of-range levels...
July 18, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28735650/prognostic-utility-of-neuroinjury-biomarkers-in-post-out-of-hospital-cardiac-arrest-ohca-patient-management
#2
S S Gul, K W Huesgen, K K Wang, K Mark, J A Tyndall
Despite aggressive intervention, patients who survive an out-of-hospital cardiac arrest (OHCA) generally have very poor prognoses, with nationwide survival rates of approximately 10-20%. Approximately 90% of survivors will have moderate to severe neurological injury ranging from moderate cognitive impairment to brain death. Currently, few early prognostic indicators are considered reliable enough to support patients' families and clinicians' in their decisions regarding medical futility. Blood biomarkers of neurological injury after OHCA may be of prognostic value in these cases...
August 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/28734936/rehabilitation-interventions-for-upper-limb-function-in-the-first-four-weeks-following-stroke-a-systematic-review-and-meta-analysis-of-the-evidence
#3
REVIEW
Kimberley A Wattchow, Michelle N McDonnell, Susan L Hillier
OBJECTIVE: To investigate the therapeutic interventions reported in the research literature, and synthesize their effectiveness in improving upper limb (UL) function in the first four weeks post-stroke. DATA SOURCES: Electronic databases, trial registries and hand searching was conducted, from inception until June 2016. STUDY SELECTION: Randomised controlled trials (RCTs), controlled trials and interventional studies with pre/post-test design were included for adults within four weeks of any type of stroke with UL impairment...
July 19, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28732512/prolonged-acute-care-and-post-acute-care-admission-and-recovery-of-physical-function-in-survivors-of-acute-respiratory-failure-a-secondary-analysis-of-a-randomized-controlled-trial
#4
Anna Neumeier, Amy Nordon-Craft, Dan Malone, Margaret Schenkman, Brendan Clark, Marc Moss
BACKGROUND: The proportion of survivors of acute respiratory failure is growing; yet, many do not regain full function and require prolonged admission in an acute or post-acute care facility. Little is known about their trajectory of functional recovery. We sought to determine whether prolonged admission influenced the trajectory of physical function recovery and whether patient age modified the recuperation rate. METHODS: We performed a secondary analysis of a randomized clinical trial of intensive physical therapy for patients with acute respiratory failure requiring mechanical ventilation for ≥4 days...
July 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28728602/robot-assisted-training-for-the-upper-limb-after-stroke-ratuls-study-protocol-for-a-randomised-controlled-trial
#5
Helen Rodgers, Lisa Shaw, Helen Bosomworth, Lydia Aird, Natasha Alvarado, Sreeman Andole, David L Cohen, Jesse Dawson, Janet Eyre, Tracy Finch, Gary A Ford, Jennifer Hislop, Steven Hogg, Denise Howel, Niall Hughes, Hermano Igo Krebs, Christopher Price, Lynn Rochester, Elaine Stamp, Laura Ternent, Duncan Turner, Luke Vale, Elizabeth Warburton, Frederike van Wijck, Scott Wilkes
BACKGROUND: Loss of arm function is a common and distressing consequence of stroke. We describe the protocol for a pragmatic, multicentre randomised controlled trial to determine whether robot-assisted training improves upper limb function following stroke. METHODS/DESIGN: Study design: a pragmatic, three-arm, multicentre randomised controlled trial, economic analysis and process evaluation. SETTING: NHS stroke services. PARTICIPANTS: adults with acute or chronic first-ever stroke (1 week to 5 years post stroke) causing moderate to severe upper limb functional limitation...
July 20, 2017: Trials
https://www.readbyqxmd.com/read/28728194/-relevance-of-living-wills-during-post-resuscitation-care
#6
Martin Christ, Katharina Isabel von Auenmüller, Martin Grett, Scharbanu Amirie, Michael Brand, Hans-Joachim Trappe
Background There is hardly any evidence about the influence of living wills on acute life-threatening disease like out-of-hospital cardiac-arrest (OHCA). We therefore initiated this study to quantify the percentage of victims of OHCA who's living wills are available during post-resuscitation care. Methods All victims of OHCA who were admitted to our hospital between January 1(st) 2008 and July 31(th) 2016 were identified by analysis of our central admission register. Data from individual patients were collected from the patient's health records and anonymously stored on a central database...
July 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28727751/oral-health-and-cardiovascular-care-perceptions-of-people-with-cardiovascular-disease
#7
Paula Sanchez, Bronwyn Everett, Yenna Salamonson, Shilpi Ajwani, Sameer Bhole, Joshua Bishop, Karen Lintern, Samantha Nolan, Rohan Rajaratnam, Julie Redfern, Maria Sheehan, Fiona Skarligos, Lissa Spencer, Ravi Srinivas, Ajesh George
MAIN OBJECTIVE: The aim of this study was to explore the perception of patients with cardiovascular disease towards oral health and the potential for cardiac care clinicians to promote oral health. METHOD: A needs assessment was undertaken with twelve patients with cardiovascular disease attending cardiac rehabilitation between 2015 and 2016, in three metropolitan hospitals in Sydney, Australia. These patients participated in face-to-face semi-structured interviews...
2017: PloS One
https://www.readbyqxmd.com/read/28727670/effect-of-psychosocial-and-vocational-interventions-on-return-to-work-rates-post-acute-myocardial-infarction-a-systematic-review
#8
Lisa OʼBrien, Sonal Wallace, Lorena Romero
PURPOSE: To examine whether the effects of psychosocial and vocational interventions delivered in the first 3 mo post-acute myocardial infarction (AMI) are effective for improving work outcomes compared with other interventions. METHODS: A search was completed for English language publications up to March 2016 across 4 electronic databases and gray literature. Inclusion criteria were (1) psychosocial and/or vocational interventions; (2) adults 18 years or older with an AMI who were within the first 3 mo post-AMI; (3) randomized or clinically controlled trials; and (4) reporting of at least 1 return-to-work (RTW) outcome: including return to paid/unpaid employment, either full-time or part-time, to the previous job role or on modified duties...
July 19, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28727183/a-randomised-controlled-trial-on-a-nurse-led-smartphone-based-self-management-programme-for-patients-with-poorly-controlled-type-2-diabetes-a-study-protocol
#9
Wenru Wang, Betsy Seah, Ying Jiang, Violeta Lopez, Cherry Tan, Suan Tee Lim, Hongliang Ren, Yin Hao Khoo
AIM: To develop and compare a nurse-led smartphone-based self-management programme with an existing nurse-led diabetes service on health-related outcomes for patients with poorly controlled type 2 diabetes in Singapore. BACKGROUND: Over the past decades, Asia has emerged as the 'diabetes epicentre' in the world due to rapid economic development, urbanisation and nutrition transition. There is an urgent need to develop more effective care management strategies in response to this rising diabetes epidemic...
July 20, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28726539/rethinking-transitions-of-care-an-interprofessional-transfer-triage-protocol-in-post-acute-care
#10
Radha V Patel, Lauri Wright, Brittany Hay
Readmissions to hospitals from post-acute care (PAC) units within long-term care settings have been rapidly increasing over the past decade, and are drivers of increased healthcare costs. With an average of $11,000 per admission, there is a need for strategies to reduce 30-day preventable hospital readmission rates. In 2018, incentives and penalties will be instituted for long-term care facilities failing to meet all-cause, all-condition hospital readmission rate performance measures. An interprofessional team (IPT) developed and implemented a Transfer Triage Protocol used in conjunction with the INTERACT programme to enhance clinical decision-making and assess the potential to reduce the facility's 30-day preventable hospital readmission rates by 10% within 6 weeks of implementation...
July 20, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28720258/feasibility-and-acceptability-of-the-use-of-patient-reported-outcome-measures-proms-in-the-delivery-of-nurse-led-supportive-care-to-people-with-colorectal-cancer
#11
Grigorios Kotronoulas, Constantina Papadopoulou, Lorna MacNicol, Mhairi Simpson, Roma Maguire
PURPOSE: Logistical issues pertinent to the use of patient-reported outcome measures (PROMs) by colorectal cancer nurse specialists (CNS) to identify the needs of people with colorectal cancer (CRC) in acute care remain unknown. We explored the feasibility and acceptability of PROMs-driven, CNS-led consultations to enhance delivery of supportive care to people with CRC completing adjuvant chemotherapy. METHODS: A systematic literature review and focus groups with patients and CNS (Phase 1) were followed by a repeated-measures, exploratory study (Phase 2), whereby pre-consultation PROM data were collected during three consecutive, monthly consultations, and used by the CNS to enable delivery of personalised supportive care...
August 2017: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
https://www.readbyqxmd.com/read/28716775/acute-rehabilitation-after-resuscitative-endovascular-balloon-occlusion-of-the-aorta-reboa-in-major-trauma
#12
Jessica Anne Rich, Julia Coleman, Camille Devaux, Karen Hoffman
We report a 23-year-old woman admitted post cyclist versus heavy goods vehicle accident in December 2014. This was the second case the life-saving procedure, that is, resuscitative endovascular balloon occlusion of the aorta (REBOA) was performed on at the roadside. This advanced procedure was performed due to the extensive haemorrhage from this patient's complex pelvic fracture . As a result of REBOA, the patient consequently lost her left lower limb and underwent a variety of complex pelvic and lower limb surgeries...
July 17, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28716014/the-comprehensive-post-acute-stroke-services-compass-study-design-and-methods-for-a-cluster-randomized-pragmatic-trial
#13
Pamela W Duncan, Cheryl D Bushnell, Wayne D Rosamond, Sara B Jones Berkeley, Sabina B Gesell, Ralph B D'Agostino, Walter T Ambrosius, Blair Barton-Percival, Janet Prvu Bettger, Sylvia W Coleman, Doyle M Cummings, Janet K Freburger, Jacqueline Halladay, Anna M Johnson, Anna M Kucharska-Newton, Gladys Lundy-Lamm, Barbara J Lutz, Laurie H Mettam, Amy M Pastva, Mysha E Sissine, Betsy Vetter
BACKGROUND: Patients discharged home after stroke face significant challenges managing residual neurological deficits, secondary prevention, and pre-existing chronic conditions. Post-discharge care is often fragmented leading to increased healthcare costs, readmissions, and sub-optimal utilization of rehabilitation and community services. The COMprehensive Post-Acute Stroke Services (COMPASS) Study is an ongoing cluster-randomized pragmatic trial to assess the effectiveness of a comprehensive, evidence-based, post-acute care model on patient-centered outcomes...
July 17, 2017: BMC Neurology
https://www.readbyqxmd.com/read/28714558/everolimus-and-reduced-calcineurin-inhibitor-therapy-in-pediatric-liver-transplant-recipients-results-from-a-multicenter-prospective-study
#14
Rainer Ganschow, Bo-Goran Ericzon, Anil Dhawan, Khalid Sharif, El-Djouher Martzloff, Barbara Rauer, Jennifer Ng, Patricia Lopez
In a 24-month, multicenter, single-arm, prospective study, 56 pediatric liver transplant patients with or without basiliximab induction were converted at 1-6 months post-transplant from standard calcineurin inhibitor (CN) therapy (± mycophenolic acid), to everolimus with reduced exposure to CNI (tacrolimus n=50, cyclosporine n=6). Steroid therapy was optional. Recruitment was stopped prematurely due to high rates of PTLD, treatment-related serious infections leading to hospitalization and premature study drug discontinuation...
July 17, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28713853/factors-associated-with-acute-postoperative-pain-following-breast-reconstruction
#15
Anita R Kulkarni, Andrea L Pusic, Jennifer B Hamill, Hyungjin M Kim, Ji Qi, Edwin G Wilkins, Randy S Roth
INTRODUCTION: Post-mastectomy breast reconstruction has become an increasingly important component of breast cancer treatment. Unfortunately, some patients experience severe postoperative pain, placing them at risk for increased clinical morbidity and the development of disabling chronic pain. In an attempt to identify at-risk patients, we prospectively evaluated patient characteristics and medical/surgical variables associated with more severe acute post-reconstruction pain. METHODS: Women (N = 2207; one-week 82...
March 2017: JPRAS Open
https://www.readbyqxmd.com/read/28713659/a-descriptive-report-of-early-mobilization-for-critically-ill-ventilated-patients-with-cancer
#16
Amanda Weeks, Claudine Campbell, Prabalini Rajendram, Weiji Shi, Louis Voigt
BACKGROUND: Early mobilization protocols have been successfully implemented to improve function in critically ill patients; however, no study has focused on the oncology population. OBJECTIVES: To investigate the feasibility of early mobilization and describe the rehabilitation interventions and discharge outcomes in a cohort of critically ill patients with cancer. DESIGN: Retrospective review. METHODS: A retrospective analysis of patients with cancer who participated in occupational and physical therapy while on mechanical ventilation utilizing an institutional early mobilization protocol from June 2010 - July 2011, was completed...
July 2017: Rehabilitation Oncology
https://www.readbyqxmd.com/read/28713493/a-new-strategy-in-neurocritical-care-nurse-continuing-stroke-education-a-hybrid-simulation-pilot-study
#17
Christopher Ryan Newey, Robert Bell, Melody Burks, Premkumar Nattanmai
INTRODUCTION: High-fidelity simulation is frequently utilized in medical education. Its use in the neurosciences is limited by the inherent limitations of the manikin to simulate neurological changes. We report here the use of a hybrid simulation - a combination of lecture and high-fidelity manikin - in the education of neurosciences nurses, involved in care of neurocritical care patients. METHODS: Neurosciences nurses from at the University of Missouri, Columbia, MO, USA, which is an academic, tertiary-care medical center participated in the simulation during Spring of 2016...
May 2017: Electronic Physician
https://www.readbyqxmd.com/read/28710987/the-long-term-quality-of-life-in-patients-with-persistent-inflammation-immunosuppression-and-catabolism-syndrome-after-severe-acute-pancreatitis-a-retrospective-cohort-study
#18
Na Yang, Baiqiang Li, Bo Ye, Lu Ke, Faxi Chen, Guotao Lu, Fangfang Jiang, Zhihui Tong, Jieshou Li, Weiqin Li
PURPOSE: To explore clinical characteristics and long-term quality of life (QOL) in severe acute pancreatitis (SAP) patients with persistent inflammation-immunosuppression and catabolism syndrome (PICS). MATERIALS AND METHODS: SAP patients admitted to ICU were eligible for the retrospective cohort study if they needed prolonged intensive care (>14days). Post-ICU QOL was assessed by a questionnaire, including 36-item Short Form Health Survey (SF-36) and record of re-work in a long-term follow-up...
July 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28710776/outcomes-of-patients-diagnosed-with-acute-myeloid-leukemia-after-solid-organ-transplantation
#19
Konstantinos Lontos, Mounzer Agha, Anastasios Raptis, Jing-Zhou Hou, Rafic Farah, Robert L Redner, Annie Im, Kathleen A Dorritie, Alison Sehgal, James Rossetti, Melissa Saul, William E Gooding, Abhinav Humar, Michael Boyiadzis
Organ transplant recipients are at an increased risk for subsequent cancer including acute myeloid leukemia (AML). Treatment of AML following solid transplantation represents a clinical challenge since most patients have significant co-morbidities at the time of AML diagnosis. In the current study, we evaluated the treatment and outcomes of patients who developed AML following solid organ transplantation at our institution and reviewed the literature on outcomes for these patients. The study cohort consisted of 14 patients (median age 66 years, range 52-77 years) with newly diagnosed AML following solid organ transplantation...
July 14, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/28709419/the-clinical-and-virological-features-of-the-first-imported-case-causing-mers-cov-outbreak-in-south-korea-2015
#20
Ji Yeon Lee, You-Jin Kim, Eun Hee Chung, Dae-Won Kim, Ina Jeong, Yeonjae Kim, Mi-Ran Yun, Sung Soon Kim, Gayeon Kim, Joon-Sung Joh
BACKGROUND: In 2015, the largest outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection outside the Middle East occurred in South Korea. We summarized the epidemiological, clinical, and laboratory findings of the first Korean case of MERS-CoV and analyzed whole-genome sequences of MERS-CoV derived from the patient. CASE PRESENTATION: A 68-year-old man developed fever and myalgia 7 days after returning to Korea, following a 10-day trip to the Middle East...
July 14, 2017: BMC Infectious Diseases
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