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https://www.readbyqxmd.com/read/28724129/association-of-cost-sharing-with-mental-health-care-use-involuntary-commitment-and-acute-care
#1
Bastian Ravesteijn, Eli B Schachar, Aartjan T F Beekman, Richard T J M Janssen, Patrick P T Jeurissen
Importance: A higher out-of-pocket price for mental health care may lead not only to cost savings but also to negative downstream consequences. Objective: To examine the association of higher patient cost sharing with mental health care use and downstream effects, such as involuntary commitment and acute mental health care use. Design, Setting, and Participants: This difference-in-differences study compared changes in mental health care use by adults, who experienced an increase in cost sharing, with changes in youths, who did not experience the increase and thus formed a control group...
July 19, 2017: JAMA Psychiatry
https://www.readbyqxmd.com/read/28724042/hyperglycemia-in-critical-patients-determinants-of-insulin-dose-choice
#2
Aline Klitzke Paliosa, Cassiano Teixeira, Regis Goulart Rosa, Carine Raquel Blatt
Objective: To identify factors that can determine the choice of intermittent subcutaneous regular insulin dose in critically ill patients with hyperglycemia. Method: Cross-sectional study in a general adult ICU with 26 beds, data collected between September and October 2014. The variables analyzed were: sex, age, previous diagnosis of diabetes mellitus, use of corticosteroids, use of lactulose, sepsis, fasting, enteral nutrition, use of dextrose 5% in water, NPH insulin prescription and blood glucose level...
May 2017: Revista da Associação Médica Brasileira
https://www.readbyqxmd.com/read/28723900/the-natural-history-of-acute-ebola-virus-disease-among-patients-managed-in-five-ebola-treatment-units-in-west-africa-a-retrospective-cohort-study
#3
Kelly Skrable, Reshma Roshania, Michaela Mallow, Vanessa Wolfman, Matthew Siakor, Adam C Levine
INTRODUCTION: Previous studies of Ebola Virus Disease (EVD) have focused on clinical symptoms and Ebola virus (EBOV) cycle threshold (CT) values recorded at patient triage. Our study explores EVD symptoms and EBOV CT values from onset of illness to recovery or death in a diverse population of patients. METHODOLOGY/PRINCIPAL FINDINGS: We analyzed clinical care data from EBOV positive patients admitted to five Ebola treatment units in West Africa from 2014-2015. Prevalence of clinical signs/symptoms and CT values were explored using descriptive statistics...
July 19, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28723773/development-and-validation-of-risk-stratification-delirium-prediction-model-for-critically-ill-patients-a-prospective-observational-single-center-study
#4
Yu Chen, Hang Du, Bao-Hua Wei, Xue-Ni Chang, Chen-Ming Dong
The objective is to develop a model based on risk stratification to predict delirium among adult critically ill patients and whether early intervention could be provided for high-risk patients, which could reduce the incidence of delirium.We designed a prospective, observational, single-center study. We examined 11 factors, including age, APACHE-II score, coma, emergency operation, mechanical ventilation (MV), multiple trauma, metabolic acidosis, history of hypertension, delirium and dementia, and application of Dexmedetomidine Hydrochloride...
July 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28723586/a-code-icu-expedited-review-of-critically-ill-patients-is-associated-with-reduced-emergency-department-length-of-stay-and-duration-of-mechanical-ventilation
#5
Matthew L Durie, Jai N Darvall, Daniel A Hadley, Mark A Tacey
PURPOSE: To examine the effect of a system of expedited review of critically ill patients in the Emergency Department (ED) on ED length of stay (LOS) and Intensive Care Unit (ICU) outcomes. MATERIALS AND METHODS: Retrospective cohort study at a tertiary hospital comparing two 12-month periods before and after implementation of a 'Code ICU' system of expedited review of critically ill patients in the ED. All adult ED to ICU admissions were included. Separate analyses were performed for patients intubated prior to ICU admission...
July 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28723504/active-surveillance-for-small-renal-masses-when-less-is-more
#6
REVIEW
Benjamin T Ristau, Alexander Kutikov, Robert G Uzzo, Marc C Smaldone
CONTEXT: A marked increase in incidentally detected small renal masses (SRMs) has occurred over the past decade. Active surveillance (AS) has emerged as an initial management option for these patients. OBJECTIVE: (1) To determine selection criteria, assess appropriate imaging modalities and surveillance frequencies, and define triggers for delayed intervention (DI) for patients on AS. (2) To describe oncologic outcomes for patients on AS protocols. EVIDENCE ACQUISITION: The PubMed database was queried for English language articles using the keywords "surveillance" and "renal mass" or "renal cell carcinoma" or "kidney cancer...
December 15, 2016: European Urology Focus
https://www.readbyqxmd.com/read/28723252/across-the-continuum-how-inpatient-palliative-care-consultations-are-reported-in-hospital-discharge-summaries
#7
Nikki Miller, John Shuler, Deon Hayley, Jianghua He, Karin Porter-Williamson, Jessica Kalender-Rich
BACKGROUND: Inpatient Palliative Care (PC) consultations help develop a patient-centered and quality-of-life-focused plan of care for patients with serious illness. Discharge summaries (DSs) are an essential tool to maintain continuity of these care plans across multiple locations and providers. METHODS: We conducted a retrospective chart review of selected DSs of patients who received inpatient PC consultations at the University of Kansas Hospital from July 2011 to May 2015...
July 19, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28722827/being-diagnosed-with-cancer-the-experiences-of-patients-with-non-hodgkin-s-lymphoma
#8
Daren Chircop, Josianne Scerri
AIMS AND OBJECTIVES: The aim of this study was to explore the lived experiences of patients on receiving a diagnosis of non-Hodgkin's lymphoma. BACKGROUND: Persons with non-Hodgkin's lymphoma are often diagnosed with cancer when at an advanced stage. This may arise due to a lack of screening programs and delays in help seeking as the symptoms experienced are fairly non-specific in nature. Consequently, receiving an unexpected diagnosis of non-Hodgkin's lymphoma may pose a psychosocial challenge to the individual...
July 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28722814/health-promoting-conversations-a-novel-approach-to-families-experiencing-critical-illness-in-the-icu-environment
#9
Gunilla Hollman Frisman, Ingrid Wåhlin, Lotti Orwelius, Susanna Ågren
AIMS AND OBJECTIVES: The aim of this study was to identify and describe the outcomes of a nurse-led intervention, "Health-promoting conversations with families," regarding family functioning and well-being in families with a member who was critically ill. BACKGROUND: Families who have a critically ill family member in an intensive care unit face a demanding situation, threatening the normal functioning of the family. Yet, there is a knowledge gap regarding family members' well-being during and after critical illness...
July 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28722620/case-report-infectious-diseases-in-pilgrims-visiting-the-holy-land
#10
Orna Nitzan, Arnon Blum, Esther Marva, Adina Katz, Bat-Sheva Tzadok, Yaarit Nachum-Biala, Gad Baneth, Avi Peretz
Every year Christian pilgrims from around the world visit the holy sites located around the Sea of Galilee. Some become ill during their stay with infectious diseases that were acquired in their country of origin, and are hospitalized at Poriya Medical Center. They pose a diagnostic challenge due to language barriers, the rarity of these infections in Israel, and the fact that diagnostic tests are not readily available. All patient records from 2015 of Holy Land tourists hospitalized at Poriya Medical Center were screened for the diagnosis of imported zoonotic diseases that are not commonly diagnosed in Israel...
May 30, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28722594/fatal-leptospira-spp-zika-virus-coinfection-puerto-rico-2016
#11
Paige Neaterour, Aidsa Rivera, Renee L Galloway, Myriam Garcia Negrón, Brenda Rivera-Garcia, Tyler M Sharp
Coinfection with pathogens that cause acute febrile illness (AFI) can complicate patient diagnosis and management. This report describes a fatal case of Leptospira spp./Zika virus (ZIKV) coinfection in Puerto Rico. The patient presented with a 5-day history of AFI; reported behavioral risk factors for leptospirosis; was diagnosed with possible leptospirosis, dengue, chikungunya, or ZIKV disease; and received appropriate treatment of leptospirosis and dengue. Following a 3-day hospitalization, the patient died due to acute gastrointestinal hemorrhage, and kidney and liver failure...
June 26, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28722568/epidemiology-of-spotted-fever-group-rickettsioses-and-acute-undifferentiated-febrile-illness-in-villeta-colombia
#12
Álvaro A Faccini-Martínez, Alejandro Ramírez-Hernández, Christian Barreto, Elkin Forero-Becerra, Diego Millán, Elkin Valbuena, Andrea C Sánchez-Alfonso, Wilson O Imbacuán-Pantoja, Jesús A Cortés-Vecino, Luis J Polo-Terán, Néstor Yaya-Lancheros, Jorge Jácome, Ana M Palomar, Sonia Santibáñez, Aránzazu Portillo, José A Oteo, Marylin Hidalgo
Etiology of acute undifferentiated febrile syndrome (AUFS) is often unknown, leading to inaccurate diagnosis and treatment. Villeta town has been identified as an endemic area for spotted fever group (SFG) rickettsioses but little is known about possible amplifier hosts and other Rickettsia species different from Rickettsia rickettsii. Besides, few studies have approached other AUFS etiologies in the region. We investigated the role of dengue, leptospirosis, rickettsioses, human anaplasmosis, and Q fever as possible causes of AUFS in patients from Villeta...
June 19, 2017: American Journal of Tropical Medicine and Hygiene
https://www.readbyqxmd.com/read/28722481/clinical-management-of-pediatric-acute-onset-neuropsychiatric-syndrome-part-i-psychiatric-and-behavioral-interventions
#13
Margo Thienemann, Tanya Murphy, James Leckman, Richard Shaw, Kyle Williams, Cynthia Kapphahn, Jennifer Frankovich, Daniel Geller, Gail Bernstein, Kiki Chang, Josephine Elia, Susan Swedo
OBJECTIVE: This article outlines the consensus guidelines for symptomatic treatment for children with Pediatric Acute-Onset Neuropsychiatric Syndrome (PANS) and Pediatric Autoimmune Neuropsychiatric Syndrome Associated with Streptococcal Infection (PANDAS). METHODS: Extant literature on behavioral, psychotherapeutic, and psychopharmacologic treatments for PANS and PANDAS was reviewed. Members of the PANS Research Consortium pooled their clinical experiences to find agreement on treatment of PANS and PANDAS symptoms...
July 19, 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/28722454/-chronic-urticaria-new-views-on-diagnosis-and-treatment-of-disease
#14
Dana Prusíková
Interest in chronic urticaria has grown in recent years, largely owing to the advent of new modes treatment especially in the form of the biologic preparation omalizumab. New scientific and clinical findings have not only facilitated a more comprehensive view of the disease but have streamlined the classification and diagnostic approach as well. Diagnostics are no longer burdened by cumbersome and lengthy investigative procedures into the etiology of urticaria, but are much more rapid and targeted bringing about more timely relief of the patient's symptoms...
2017: Casopís Lékar̆ů C̆eských
https://www.readbyqxmd.com/read/28722087/-standardized-diagnosis-and-treatment-of-colorectal-liver-metastasis
#15
Hongwei Yao, Zhongtao Zhang
Colorectal cancer is one of the most common malignancies. The liver is the most common site of distant metastasis, and liver metastasis is the leading cause of death in the patients with colorectal cancer. In recent years, the concept of diagnosis and treatment in colorectal liver metastasis (CLM) and the liver surgery techniques developed rapidly, the standardization of clinical practice elevated obviously, and the survival outcomes of more and more patients were significantly improved. Standardization of diagnosis and treatment in CLM comprised overall assessment of patients' condition and local tumor status based on multidisciplinary team collaboration and then institution of treatment strategy...
July 25, 2017: Zhonghua Wei Chang Wai Ke za Zhi, Chinese Journal of Gastrointestinal Surgery
https://www.readbyqxmd.com/read/28721432/influence-of-age-on-decision-making-process-to-limit-or-withdraw-life-sustaining-treatment-in-the-intensive-care-unit-a-single-center-prospective-observational-study
#16
G Ducos, O Mathe, L Balardy, S Lozano, M Kurrek, J Ruiz, B Riu-Poulenc, O Fourcade, S Silva, V Minville
BACKGROUND: The increasing age in the industrialized countries places significant demands on intensive care unit (ICU) resources and this triggers debates about end-of-life care for the elderly. OBJECTIVES: We sought to determine the impact of age on the decision-making process to limit or withdraw life-sustaining treatment (DWLST) in an ICU in France. We hypothesized that there are differences in the decision-making process for young and old patients. DESIGN, SETTING, PARTICIPANTS: We prospectively studied end-of-life decision-making for all consecutive admissions (n=390) to a tertiary care university ICU in Toulouse, France over a period of 11 months between January and October 2011...
2017: Journal of Frailty & Aging
https://www.readbyqxmd.com/read/28721347/peliosis-hepatis-complicating-pregnancy-a-rare-entity
#17
Muhammad Osama Butt, Nasir Hassan Luck, Syed Mujahid Hassan, Zaigham Abbas, Muhammed Mubarak
Peliosis hepatis (PH) is a rare, benign condition of the liver characterized by the presence of blood-filled lacunar spaces in the parenchyma. It usually has a chronic presentation and is a rare cause of portal hypertension reported in adult patients. Its etiology is diverse and ranges from infectious agents to tumors to toxic substances and anabolic steroids; however, the cause remains unclear in 25-50% of patients. Similarly, the symptomatology and imaging findings are diverse. Biopsy is the definitive test to diagnose the condition...
June 2017: Journal of Translational Internal Medicine
https://www.readbyqxmd.com/read/28721319/combined-sacroplasty-and-iliosacral-fixation-using-triangular-titanium-implants-for-the-treatment-of-sacral-insufficiency-fractures-with-concomitant-sacral-instability
#18
Ryan Johnson, Jason Seibly
Sacral insufficiency fractures (SIFs) are a common, under-recognized cause of debilitating low back pain, particularly in elderly patients with osteoporotic bone disease or risk factors for bone demineralization. Conservative therapy has been the mainstay of treatment for these types of fractures. This places patients at increased risk for the development of secondary illnesses associated with prolonged immobility, which might prevent a full return to the preinjury level of function. Surgical intervention for SIFs has increased over the past two decades in an attempt to overcome these complications and improve patient functionality...
June 14, 2017: Curēus
https://www.readbyqxmd.com/read/28721222/serological-evidence-of-francisella-tularensis-in-febrile-patients-seeking-treatment-at-remote-hospitals-northeastern-kenya-2014-2015
#19
J Njeru, H Tomaso, K Mertens, K Henning, G Wareth, R Heller, S Kariuki, E M Fèvre, H Neubauer, M W Pletz
Tularaemia is a highly contagious infectious zoonosis caused by the bacterial agent Francisella tularensis. The aim of this study was to investigate the presence of antibodies to F. tularensis in febrile patients in northeastern Kenya. During 2014-2015, 730 patients were screened for anti-F. tularensis antibodies using a combination of ELISA and Western blot. Twenty-seven (3.7%) individuals were positive for F. tularensis. Tularaemia was not suspected by the treating clinicians in any of them. Our results suggest that tularaemia may be present in Kenya but remain unreported, and emphasizes the need for local clinicians to broaden their diagnostic repertoire when evaluating patients with undifferentiated febrile illness...
September 2017: New Microbes and New Infections
https://www.readbyqxmd.com/read/28721086/adaptation-to-illness-in-relation-to-pain-perceived-by-patients-after-surgery
#20
Mariusz Chabowski, Michał Junke, Jan Juzwiszyn, Magdalena Milan, Maciej Malinowski, Dariusz Janczak
BACKGROUND: Pain is one of the factors that decrease quality of life. Undergoing surgery is inevitably associated with the sensation of pain, which can affect a patient's level of acceptance of an illness. The aim of the study was to evaluate the level of acceptance of illness in patients undergoing surgical treatment with relation to the pain perceived by them during surgical treatment and to determine other factors that affect adaptation to illness among patients subjected to invasive treatment...
2017: Journal of Pain Research
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