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https://www.readbyqxmd.com/read/28448264/use-of-ovine-based-collagen-extracellular-matrix-and-gentian-violet-methylene-blue-antibacterial-foam-dressings-to-help-improve-clinical-outcomes-in-lower-extremity-wounds-a-retrospective-cohort-study
#1
Eric L Lullove
Dressings that provide broad spectrum metalloprotease reduction along with inherent aspects of an extracellular matrix may contribute to improved wound healing outcomes and shorter treatment times. OBJECTIVE: The author performed a retrospective case series analysis to determine the clinical outcomes of regular debridement with the use of ovine-based collagen extracellular matrix dressings and gentian violet/methylene blue polyurethane antibacterial foam dressings in treating 53 patients with 53 chronic lower extremity wounds (diabetic foot ulcers [DFUs], venous leg ulcers, and heel pressure ulcers)...
April 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28448222/patient-experience-and-process-measures-of-quality-of-care-at-home-health-agencies-factors-associated-with-high-performance
#2
Laura M Smith, Wayne L Anderson, Lisa M Lines, Cristalle Pronier, Vanessa Thornburg, Janelle P Butler, Lori Teichman, Debra Dean-Whittaker, Elizabeth Goldstein
We examined effects of provider characteristics on home health agency performance on patient experience of care (Home Health CAHPS) and process (OASIS) measures. Descriptive, multivariate, and factor analyses were used. While agencies score high on both domains, factor analyses showed that the underlying items represent separate constructs. Freestanding and Visiting Nurse Association agencies, higher number of home health aides per 100 episodes, and urban location were statistically significant predictors of lower performance...
April 27, 2017: Home Health Care Services Quarterly
https://www.readbyqxmd.com/read/28447302/comment-on-the-new-indian-injection-technique-recommendations-critical-appraisal-of-the-real-world-implementation-of-the-current-guidelines
#3
Felice Strollo, Sandro Gentile
With an eye on the sequence of two Indian papers concurrently published in Diabetes Therapy, this paper analyzes skin differences among races and points to a lack of organized structured education sessions as the main cause of the high prevalence of lipodystrophy (LD) and consequent poor metabolic control. Only half of all insulin-treated patients reach their therapeutic targets worldwide. The factors involved in this are manifold, including the choice of overlong and repeatedly reused needles, as well as a failure to systematically rotate injection sites, all of which lead to skin LD...
April 26, 2017: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/28446116/risk-adjusted-hospital-mortality-rates-for-stroke-evidence-from-the-australian-stroke-clinical-registry-auscr
#4
Dominique A Cadilhac, Monique F Kilkenny, Christopher R Levi, Natasha A Lannin, Amanda G Thrift, Joosup Kim, Brenda Grabsch, Leonid Churilov, Helen M Dewey, Kelvin Hill, Steven G Faux, Rohan Grimley, Helen Castley, Peter J Hand, Andrew Wong, Geoffrey K Herkes, Melissa Gill, Douglas Crompton, Sandy Middleton, Geoffrey A Donnan, Craig S Anderson
OBJECTIVES: Hospital data used to assess regional variability in disease management and outcomes, including mortality, lack information on disease severity. We describe variance between hospitals in 30-day risk-adjusted mortality rates (RAMRs) for stroke, comparing models that include or exclude stroke severity as a covariate. DESIGN: Cohort design linking Australian Stroke Clinical Registry data with national death registrations. Multivariable models using recommended statistical methods for calculating 30-day RAMRs for hospitals, adjusted for demographic factors, ability to walk on admission, stroke type, and stroke recurrence...
May 1, 2017: Medical Journal of Australia
https://www.readbyqxmd.com/read/28444409/diagnostic-work-up-and-specific-causes-of-acute-kidney-injury
#5
REVIEW
Michael Darmon, Marlies Ostermann, Jorge Cerda, Meletios A Dimopoulos, Lui Forni, Eric Hoste, Matthieu Legrand, Nicolas Lerolle, Eric Rondeau, Antoine Schneider, Bertrand Souweine, Miet Schetz
Acute kidney injury (AKI) is common in critically ill patients and associated with grim short- and long-term outcome. Although in the vast majority of cases AKI is multifactorial, with sepsis, shock and nephrotoxicity accounting for most episodes, specific causes of AKI are not uncommon. Despite remaining uncertainties regarding their prevalence in the ICU, prompt recognition of specific aetiologies of AKI is likely to ensure timely management, limit worsening of renal dysfunction, and ultimately limit renal and systemic consequences of AKI...
April 25, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28444279/trends-in-infective-endocarditis-in-california-and-new-york-state-1998-2013
#6
Nana Toyoda, Joanna Chikwe, Shinobu Itagaki, Annetine C Gelijns, David H Adams, Natalia N Egorova
Importance: Prophylaxis and treatment guidelines for infective endocarditis have changed substantially over the past decade. In the United States, few population-based studies have explored the contemporary epidemiology and outcomes of endocarditis. Objective: To quantify trends in the incidence and etiologies of infective endocarditis in the United States. Design, Setting, and Participants: Retrospective population epidemiology study of patients hospitalized with a first episode of endocarditis identified from mandatory state databases in California and New York State between January 1, 1998, and December 31, 2013...
April 25, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28444091/risk-factors-for-mortality-in-ventilator-associated-tracheobronchitis-a-case-control-study
#7
Leonilda Giani Pontes, Fernando Gatti de Menezes, Priscila Gonçalves, Alexandra do Rosário Toniolo, Claudia Vallone Silva, Julia Yaeko Kawagoe, Camila Marques Dos Santos, Helena Maria Fernandes Castagna, Marinês Dalla Valle Martino, Luci Corrêa
Objective: To describe the microbiological characteristics and to assess the risk factors for mortality of ventilator-associated tracheobronchitis in a case-control study of intensive care patients. Methods: This case-control study was conducted over a 6-year period in a 40-bed medical-surgical intensive care unit in a tertiary care, private hospital in São Paulo, Brazil. Case patients were identified using the Nosocomial Infection Control Committee database. For the analysis of risk factors, matched control subjects were selected from the same institution at a 1:8...
2017: Einstein
https://www.readbyqxmd.com/read/28444056/care-for-young-victims-of-assault-in-public-emergency-services-in-2011-sex-differences
#8
Alice Cristina Medeiros Melo, Leila Posenato Garcia
This article aims to describe the characteristics of assaults among youth victims of violence treated in Public Emergency Departments, according to sex. This is a descriptive study using data from the Brazilian Violence and Accidents Surveillance System based on a multicenter survey conducted by the Ministry of Health in 71 public emergency departments, located in 24 state capitals and the Federal District in 2011. Male subjects predominated among the victims (75.1%) and also among aggressors (83.1% and 69...
April 2017: Ciência & Saúde Coletiva
https://www.readbyqxmd.com/read/28444008/from-guidelines-to-local-realities-evaluation-of-oral-rehydration-therapy-and-zinc-supplementation-in-guatemala
#9
Rachel Hall-Clifford, Roxanne Amerson
Objective: Diarrhea remains a leading cause of morbidity and mortality for children in low- and middle-income countries throughout the Americas. The World Health Organization (WHO) has developed guidelines on incorporating zinc supplementation (ZS) with traditional oral rehydration therapy (ORT) in order to shorten the duration of diarrheal episodes and to reduce poor health outcomes. Guatemala adopted these guidelines in 2011, but they have not yet been fully implemented at the community level...
April 20, 2017: Revista Panamericana de Salud Pública, Pan American Journal of Public Health
https://www.readbyqxmd.com/read/28442967/a-case-report-of-suspected-malignant-hyperthermia-where-patient-survived-the-episode
#10
Asif Iqbal, Shoaib Badoo, Ruqsana Naqeeb
Malignant hyperthermia is rare inherited disorder in our part of the world; there are only few cases reported in literature in India who were suspected of having this condition. The overall incidence of malignant hyperthermia during general anesthesia is estimated to range from 1: 5000 to 1: 50,000-100,000 and mortality rate is estimated to be <5% in the presence of standard care. In India, there is no center where in vitro halothane caffeine contraction test is performed to confirm diagnosis in suspected cases...
April 2017: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/28442541/respiratory-scores-as-a-tool-to-reduce-bronchodilator-use-in-children-hospitalized-with-acute-viral-bronchiolitis
#11
Grant M Mussman, Rashmi D Sahay, Lauren Destino, Michele Lossius, Kristin A Shadman, Susan C Walley
BACKGROUND AND OBJECTIVES: Adoption of clinical respiratory scoring as a quality improvement (QI) tool in bronchiolitis has been temporally associated with decreased bronchodilator usage. We sought to determine whether documented use of a clinical respiratory score at the patient level was associated with a decrease in either the physician prescription of any dose of bronchodilator or the number of doses, if prescribed, in a multisite QI collaborative. METHODS: We performed a secondary analysis of data from a QI collaborative involving 22 hospitals...
April 25, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28441676/transitioning-from-volume-to-value-one-academic-medical-center-s-approach-to-improving-population-health
#12
Stephanie A C Halvorson, Mary E Tanski, Thomas R Yackel
PROBLEM: The U.S. health care system is undergoing a major transformation. Clinical delivery systems are now being paid according to the value of the care they provide, in accordance with the Triple Aim, which incorporates improving the quality and cost of care and the patient experience. Increasingly, financial risk is being transferred from insurers to clinical delivery systems that become responsible for both episode-based clinical care and the longitudinal care of patients. Thus, these delivery systems need to develop strategies to manage the health of populations...
May 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28440305/acute-kidney-injury-in-cirrhosis-baseline-serum-creatinine-predicts-patient-outcomes
#13
F Wong, J G O'Leary, K R Reddy, G Garcia-Tsao, M B Fallon, S W Biggins, R M Subramanian, P J Thuluvath, P S Kamath, H Patton, B Maliakkal, P Tandon, H Vargas, L Thacker, J S Bajaj
OBJECTIVES: The International Ascites Club (IAC) recently defined Stage 1 acute kidney injury (AKI) for cirrhosis as an acute increase in serum creatinine (SCr) by ≥0.3 mg/dl or by ≥50% in <48 h from a stable value within 3 months. The baseline SCr may influence AKI risk and patient outcomes. The objective of this study is to determine in cirrhosis whether the baseline SCr has any effect on the in-hospital AKI course and patient survival. METHODS: North American Consortium for the Study of End-Stage Liver Disease is a consortium of tertiary-care hepatology centers prospectively enroling non-elective cirrhotic inpatients...
April 25, 2017: American Journal of Gastroenterology
https://www.readbyqxmd.com/read/28439690/association-of-endotracheal-tube-repositioning-and-acute-laryngeal-lesions-during-mechanical-ventilation-in-children
#14
Denise Manica, Catia de Souza Saleh Netto, Cláudia Schweiger, Leo Sekine, Larissa Valency Enéas, Denise Rotta Pereira, Gabriel Kuhl, Paulo Roberto Antonacci Carvalho, Paulo José Cauduro Marostica
The objective of this study is to determine the incidence of post-extubation acute laryngeal lesions in a pediatric intensive care unit (PICU) and potential risk factors. Children, aged 28 days to 5 years, admitted to the PICU who required endotracheal intubation for at least 24 h were enrolled. Exclusion criteria were a previous intubation, history of laryngeal disease, current or past tracheostomy, the presence of craniofacial malformations and patients considered on palliative care. All patients underwent flexible fiber-optic laryngoscopy (FFL) not later than 8 h after extubation...
April 24, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/28439405/the-start-back-tool-in-chiropractic-practice-a-narrative-review
#15
REVIEW
Yasmeen Khan
BACKGROUND: The Keele STarT Back Tool was designed for primary care medical physicians in the UK to determine the risk for persistent disabling pain in patients with musculoskeletal pain and to tailor treatments accordingly. In medical and physical therapy settings, STarT Back Tool's tailored care plans improved patients' low back pain outcomes and lowered costs. OBJECTIVE: Review studies using the STarT Back Tool in chiropractic patient populations. METHODS: PubMed, The Cochrane Library, Index to Chiropractic Literature, and Science Direct databases were searched...
2017: Chiropractic & Manual Therapies
https://www.readbyqxmd.com/read/28438453/effect-of-bundled-payments-and-health-care-reform-as-alternative-payment-models-in-total-joint-arthroplasty-a-clinical-review
#16
REVIEW
Ahmed Siddiqi, Peter B White, Jaydev B Mistry, Chukwuweike U Gwam, James Nace, Michael A Mont, Ronald E Delanois
BACKGROUND: In an effort to control rising healthcare costs, healthcare reforms have developed initiatives to evaluate the efficacy of alternative payment models (APMs) for Medicare reimbursements. The Center for Medicare and Medicaid Services Innovation Center (CMMSIC) introduced the voluntary Bundled Payments for Care Improvement (BPCI) model experiment as a means to curtail Medicare cost by allotting a fixed payment for an episode of care. The purpose of this review is to (1) summarize the preliminary clinical results of the BPCI and (2) discuss how it has led to other healthcare reforms and alternative payment models...
March 20, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28437539/safety-and-efficacy-of-antiviral-therapy-for-prevention-of-cytomegalovirus-reactivation-in-immunocompetent-critically-ill-patients-a-randomized-clinical-trial
#17
Nicholas J Cowley, Andrew Owen, Sarah C Shiels, Joanne Millar, Rebecca Woolley, Natalie Ives, Husam Osman, Paul Moss, Julian F Bion
Importance: Latent cytomegalovirus (CMV) infection is present in more than half the adult population, and a viral reactivation (ie, when the virus becomes measurable in body fluids such as blood) can occur in up to one-third of these individuals during episodes of critical illness. Objective: To determine whether antiviral therapy is safe and effective for preventing CMV reactivation in a general population of critically ill patients. Design, Setting, and Participants: A single-center, open-label, randomized, controlled clinical trial recruited 124 CMV-seropositive patients undergoing mechanical ventilation for at least 24 hours in the intensive care unit between January 1, 2012, and January 31, 2014...
April 24, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28437365/a-method-to-account-for-variation-in-congenital-heart-surgery-length-of-stay
#18
Andrew Brennan, Kimberlee Gauvreau, Jean Connor, Melvin Almodovar, James DiNardo, Puja Banka, Meena Nathan, Derek Mathieu, Aditya Kaza, John E Mayer, Lisa Bergersen
OBJECTIVES: We sought to develop a risk-adjustment methodology for length of stay in congenital heart surgery, as none exist. DESIGN: Prospective cohort analysis combined with previously obtained retrospective cohort analysis of a Department of Cardiovascular Surgery clinical database. PATIENTS: Patients discharged from Boston Children's Hospital between October 1, 2006, and May 31, 2014, that underwent a congenital heart surgery procedure(s) linked to one of 103 surgical procedure types...
April 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28437195/home-health-chains-and-practice-patterns-evidence-of-2008-medicare-reimbursement-revision
#19
Sean Shenghsiu Huang, Hyunjee Kim
Home health agencies (HHAs) are known to exploit the Medicare reimbursement schedule by targeting a specific number of therapy visits. These targeting behaviors cause unnecessary medical spending. The Centers for Medicare & Medicaid Services estimates that during fiscal year 2015, Medicare made more than $10 billion in improper payments to HHAs. Better understanding of heterogeneous gaming behaviors among HHAs can inform policy makers to more effectively oversee the home health care industry. This article aims to study how home health chains adjust and adopt new targeting behaviors as compared to independent agencies under the new reimbursement schedule...
February 23, 2017: Population Health Management
https://www.readbyqxmd.com/read/28436184/delaying-cognitive-and-physical-decline-through-multidomain-interventions-for-residents-with-mild-to-moderate-dementia-in-dementia-care-units-in-taiwan-a-prospective-cohort-study
#20
Chih-Kuang Liang, Ming-Yueh Chou, Liang-Yu Chen, Kuei-Yu Wang, Shih-Yi Lin, Liang-Kung Chen, Yu-Te Lin, Tsung-Yun Liu, Ching-Hui Loh
AIM: To develop experimental multi-domain interventions for older people with mild-to-moderate dementia, and to evaluate the effect of delaying cognitive and physical decline, and improvement or prevention of geriatric syndromes during 1-year follow up. METHODS: Participants aged 65 years and older with mild-to-moderate dementia (clinical dementia rating [CDR] 1 or 2) were grouped as intervention in Jia-Li Veterans Home and usual care model in the community (Memory clinic)...
April 2017: Geriatrics & Gerontology International
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