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https://www.readbyqxmd.com/read/28636854/cluster-randomized-crossover-trial-of-head-positioning-in-acute-stroke
#1
Craig S Anderson, Hisatomi Arima, Pablo Lavados, Laurent Billot, Maree L Hackett, Verónica V Olavarría, Paula Muñoz Venturelli, Alejandro Brunser, Bin Peng, Liying Cui, Lily Song, Kris Rogers, Sandy Middleton, Joyce Y Lim, Denise Forshaw, C Elizabeth Lightbody, Mark Woodward, Octavio Pontes-Neto, H Asita De Silva, Ruey-Tay Lin, Tsong-Hai Lee, Jeyaraj D Pandian, Gillian E Mead, Thompson Robinson, Caroline Watkins
BACKGROUND: The role of supine positioning after acute stroke in improving cerebral blood flow and the countervailing risk of aspiration pneumonia have led to variation in head positioning in clinical practice. We wanted to determine whether outcomes in patients with acute ischemic stroke could be improved by positioning the patient to be lying flat (i.e., fully supine with the back horizontal and the face upwards) during treatment to increase cerebral perfusion. METHODS: In a pragmatic, cluster-randomized, crossover trial conducted in nine countries, we assigned 11,093 patients with acute stroke (85% of the strokes were ischemic) to receive care in either a lying-flat position or a sitting-up position with the head elevated to at least 30 degrees, according to the randomization assignment of the hospital to which they were admitted; the designated position was initiated soon after hospital admission and was maintained for 24 hours...
June 22, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28636843/hospital-inpatient-admissions-with-dehydration-and-or-malnutrition-in-medicare-beneficiaries-receiving-enteral-nutrition-a-cohort-study
#2
Rachel Drake, Audrey Ozols, William J Nadeau, Mary Jo Braid-Forbes
BACKGROUND: Enteral nutrition (EN) supports many older and disabled Americans. This study describes the frequency and cost of acute care hospitalization with dehydration and/or malnutrition of Medicare beneficiaries receiving EN, focusing on those receiving home EN. METHODS: Medicare 5% Standard Analytic Files were used to determine Medicare spending for EN supplies and the proportion and cost of beneficiaries receiving EN, specifically home EN, admitted to the hospital with dehydration and/or malnutrition...
June 1, 2017: JPEN. Journal of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28635194/volitional-rehabilitative-assessments-in-patients-admitted-in-a-post-intensive-care-step-down-unit-a-feasibility-study
#3
Mara Paneroni, Francesco D' Abrosca, Georges Fokom, Laura Comini, Michele Vitacca
A high variability in functional tests and activities used during the pulmonary rehabilitation has been observed in post-intensive care unit (ICU) patients, and the best battery of tests to adopt has not been described yet. We tested in patients admitted in a post-ICU Step Down Unit the ability to perform the more frequent functional volitional tests. The relations of each single volitional test with general disability and dyspnea at discharge were also evaluated. Ten volitional tests including: bedside spirometry test (ST: FEV1%, FVC%), maximal inspiratory pressure (MIP), maximal expiratory pressure (MEP), Peak Expiratory Flow during Cough (PCEF), Quadriceps Muscle Strength (QMS), latissimus Dorsi and teres Major Strength (DMS), Brachial biceps Muscle Strength (BMS), effort tolerance measured by sit-to-stand test, Takahashi test and 6-Min Walking Test (6MWT), were evaluated in post-ICU patients at entry and discharge from in-hospital rehabilitation...
May 18, 2017: Monaldi Archives for Chest Disease, Archivio Monaldi Per le Malattie del Torace
https://www.readbyqxmd.com/read/28633545/late-recovery-of-awareness-in-prolonged-disorders-of-consciousness-a-cross-sectional-cohort-study
#4
Kudret Yelden, Sophie Duport, Leon M James, Agnieszka Kempny, Simon F Farmer, Alex P Leff, E Diane Playford
PURPOSE: To detect any improvement of awareness in prolonged disorders of consciousness in the long term. METHODS: A total of 34 patients with prolonged disorders of consciousness (27 vegetative state and seven minimally conscious state; 16 males; aged 21-73) were included in the study. All patients were initially diagnosed with vegetative/minimally conscious state on admission to our specialist neurological rehabilitation unit. Re-assessment was performed 2-16 years later using Coma Recovery Scale-Revised...
June 21, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28623944/the-effect-of-combining-manual-therapy-with-exercise-for-mild-chronic-obstructive-pulmonary-disease-study-protocol-for-a-randomised-controlled-trial
#5
Roger M Engel, Jaxson Wearing, Peter Gonski, Subramanyam Vemulpad
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major cause of disability and hospital admission. Current management strategies have not been successful in altering the loss of lung function typically seen as the disease progresses. A recent systematic review into the use of spinal manipulative therapy (SMT) in the management of COPD concluded that there was low level evidence to support the view that a combination of SMT and exercise had the potential to improve lung function more than exercise alone in people with moderate to severe COPD...
June 17, 2017: Trials
https://www.readbyqxmd.com/read/28623119/the-cost-effectiveness-of-a-stroke-unit-in-providing-enhanced-patient-outcomes-in-an-australian-teaching-hospital
#6
Shaun Zhai, Fergus Gardiner, Teresa Neeman, Brett Jones, Yash Gawarikar
BACKGROUND: Stroke is one of the leading causes of disability and mortality. Patients who receive organized inpatient care in a stroke unit (SU) have better clinical outcomes. However, evidence on the cost analysis of an SU is lacking. The objective of this study was to assess the performance and analyze the cost-effectiveness of an SU. METHODS: A retrospective observational study was conducted comparing the acute stroke patient care in a 6-month period before and after the establishment of an acute SU at Calvary Hospital in 2013-2014...
June 13, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28623040/-neuro-ophthalmological-conditions-study-of-the-clinical-care-pathway
#7
I Layat, G Challe, P LeHoang, B Bodaghi, V Touitou
INTRODUCTION: Neuro-ophthalmologic conditions require specialized multidisciplinary management, both medical and surgical, for patients affected by visual loss due to nervous system disease. The primary goal of this study is to define the specificity of neuro-ophthalmology within the realm of visual health. The secondary goal is to review clinical care pathways by studying the organization of management, in terms of accessibility to care and personalization of the care pathway. PATIENTS AND METHODS: A field study was carried out from February to June 2015, within the ophthalmology service of the Pitié-Salpêtrière University Medical Center in Paris...
June 13, 2017: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/28619687/use-of-the-central-sensitization-inventory-csi-as-a-treatment-outcome-measure-for-chronic-spinal-pain-disorder-patients-in-a-functional-restoration-program
#8
Randy Neblett, Meredith M Hartzell, Mark Williams, Kelley R Bevers, Tom G Mayer, Robert J Gatchel
BACKGROUND CONTEXT: The Central Sensitization Inventory (CSI) is a valid and reliable patient-reported instrument designed to identify patients whose presenting symptoms may be related to Central Sensitization (CS). Part A of the CSI measures a full array of 25 somatic and emotional symptoms associated with CS, and Part B asks if patients have previously been diagnosed with one or more specific Central Sensitivity Syndromes (CSSs) and related disorders. The CSI has previously been validated in a group of chronic pain patients who were screened by a trained psychiatrist for specific CSS diagnoses...
June 12, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28613408/pre-admission-antibiotics-for-suspected-cases-of-meningococcal-disease
#9
REVIEW
Thambu D Sudarsanam, Priscilla Rupali, Prathap Tharyan, Ooriapadickal Cherian Abraham, Kurien Thomas
BACKGROUND: Meningococcal disease can lead to death or disability within hours after onset. Pre-admission antibiotics aim to reduce the risk of serious disease and death by preventing delays in starting therapy before confirmation of the diagnosis. OBJECTIVES: To study the effectiveness and safety of pre-admission antibiotics versus no pre-admission antibiotics or placebo, and different pre-admission antibiotic regimens in decreasing mortality, clinical failure, and morbidity in people suspected of meningococcal disease...
June 14, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28612475/how-hiv-affects-health-and-service-use-for-adults-with-intellectual-and-developmental-disabilities
#10
A Durbin, H K Brown, S Bansal, T Antoniou, J K H Jung, Y Lunsky
OBJECTIVE(S): Although rates of human immunodeficiency virus (HIV) are similar for individuals with and without intellectual and developmental disabilities (IDD), very little is known about the health needs and service use of those with IDD and HIV. Among a population with IDD, we compared the physical and mental health profiles, as well as general and mental health service use for those with and without HIV. DESIGN: Retrospective cohort study in Ontario, Canada using linked administrative health and social service databases...
July 2017: Journal of Intellectual Disability Research: JIDR
https://www.readbyqxmd.com/read/28607671/epidemiology-of-ocular-trauma-in-children-requiring-hospital-admission-a-16-year-retrospective-cohort-study
#11
Kajo Bućan, Anita Matas, Josipa Marin Lovrić, Darko Batistić, Ivna Pleština Borjan, Livia Puljak, Ivona Bućan
BACKGROUND: To study the epidemiology of ocular trauma requiring hospital admission in children under 18 years in age. METHODS: This retrospective cohort study included pediatric patients with ocular injuries at the Ophthalmology Department of the Clinical Hospital Centre, Split, Croatia, from 2000 to 2015, classified according to the Birmingham Eye Trauma Terminology. RESULTS: There were 353 children hospitalized, 82% of boys (mean age 11 years) and 18% of girls (mean age 10 years)...
June 2017: Journal of Global Health
https://www.readbyqxmd.com/read/28606660/the-addition-of-endovascular-intervention-for-dural-venous-sinus-thrombosis-single-center-experience-and-review-of-literature
#12
Eric M Nyberg, David Case, Lidia M Nagae, Justin M Honce, William Reyenga, Joshua Seinfeld, Sharon Poisson, Michelle H Leppert
BACKGROUND: Dural venous sinus thrombosis (DVST) is a cause of infarction and intracranial hemorrhage (ICH) that can lead to significant morbidity. Endovascular therapy has emerged as an adjunctive therapy in select cases but has been associated with increased hemorrhagic complications. We present our experience with a large single-center cohort of DVST cases treated with current-generation thrombectomy devices. MATERIALS AND METHODS: In this retrospective cohort study, a chart review was performed to compare presentations and outcomes of patients treated with anticoagulation alone with those treated with additional interventional therapy, using the modified Rankin Scale (mRS) score at discharge and at 90 days' follow-up...
June 9, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28605738/spatial-neglect-predicts-upper-limb-use-in-the-activities-of-daily-living
#13
Tim Vanbellingen, Beatrice Ottiger, Noortje Maaijwee, Tobias Pflugshaupt, Stephan Bohlhalter, René M Müri, Tobias Nef, Dario Cazzoli, Thomas Nyffeler
BACKGROUND AND PURPOSE: Motor tests performed at stroke onset have been shown to predict the recovery of upper limb motor impairment. Less is known about upper limb recovery at the level of functional activity or of participation and how spatial neglect may influence the integration of the upper limb in the activities of daily living (ADL). Our objective was to investigate whether the initial severity of spatial neglect may predict upper limb use in ADL. METHODS: Eighty-two patients with a right-hemispheric stroke (RHS) were prospectively included in the study...
June 13, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28605426/biomarkers-of-cerebral-injury-and-inflammation-in-pediatric-tuberculous-meningitis
#14
Ursula K Rohlwink, Katya Mauff, Katalin A Wilkinson, Nico Enslin, Emmanuel Wegoye, Robert J Wilkinson, Anthony A Figaji
Background: Tuberculous meningitis (TBM) leads to death or disability in half the affected individuals. Tools to assess severity and predict outcome are lacking. Neuro-specific biomarkers could serve as markers of the severity and evolution of brain injury, but have not been widely explored in TBM. We examined biomarkers of neurological injury (neuromarkers) and inflammation in pediatric TBM and their association with outcome. Methods: Blood and cerebrospinal fluid (CSF) of children with TBM and hydrocephalus taken on admission and over 3 weeks were analysed for neuromarkers S100B, neuron-specific enolase (NSE) and glial fibrillary acidic protein (GFAP), and multiple inflammatory markers...
June 9, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/28602027/assistive-technology-for-memory-support-in-dementia
#15
REVIEW
Henriëtte G Van der Roest, Jennifer Wenborn, Channah Pastink, Rose-Marie Dröes, Martin Orrell
BACKGROUND: The sustained interest in electronic assistive technology in dementia care has been fuelled by the urgent need to develop useful approaches to help support people with dementia at home. Also the low costs and wide availability of electronic devices make it more feasible to use electronic devices for the benefit of disabled persons. Information Communication Technology (ICT) devices designed to support people with dementia are usually referred to as Assistive Technology (AT) or Electronic Assistive Technology (EAT)...
June 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28599960/neuro-ophthalmological-conditions-study-of-the-clinical-care-pathway
#16
I Layat, G Challe, P LeHoang, B Bodaghi, V Touitou
INTRODUCTION: Neuro-ophthalmologic conditions require specialized multidisciplinary management, both medical and surgical, for patients affected by visual loss due to nervous system disease. The primary goal of this study is to define the specificity of neuro-ophthalmology within the realm of visual health. The secondary goal is to review clinical care pathways by studying the organization of management, in terms of accessibility to care and personalization of the care pathway. PATIENTS AND METHODS: A field study was carried out from February to June 2015, within the ophthalmology service of the Pitié-Salpêtrière University Medical Center in Paris...
June 6, 2017: Journal Français D'ophtalmologie
https://www.readbyqxmd.com/read/28599198/hypoalbuminemia-systemic-inflammatory-response-syndrome-and-functional-outcome-in-intracerebral-hemorrhage
#17
Mario Di Napoli, Réza Behrouz, Christopher H Topel, Vivek Misra, Fulvio Pomero, Alessia Giraudo, Paolo Pennati, Luca Masotti, Floris H B M Schreuder, Julie Staals, Catharina J M Klijn, Craig J Smith, Adrian R Parry-Jones, Mark A Slevin, Brian Silver, Joshua Z Willey, Mahmoud R Azarpazhooh, Jaime Masjuán Vallejo, Hipólito Nzwalo, Aurel Popa-Wagner, Daniel A Godoy
PURPOSE: Hypoalbuminemia and systemic inflammatory response syndrome (SIRS) are reported in critically-ill patients, but their relationship is unclear. We sought to determine the association of admission serum albumin and SIRS with outcomes in patients with intracerebral hemorrhage (ICH). METHODS: We used a multicenter, multinational registry of ICH patients to select patients in whom SIRS parameters and serum albumin levels had been determined on admission. Hypoalbuminemia was defined as the lowest standardized quartile of albumin; SIRS according to standard criteria...
June 1, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28592356/use-of-health-resources-and-healthcare-costs-associated-with-nutritional-risk-the-fradea-study
#18
Marta Martínez-Reig, Isaac Aranda-Reneo, Luz M Peña-Longobardo, Juan Oliva-Moreno, Núria Barcons-Vilardell, Emiel O Hoogendijk, Pedro Abizanda
BACKGROUND: In spite of its high prevalence and its clinical relevance, the economic impact of malnutrition has not been sufficiently explored. OBJECTIVE: To study whether malnutrition predicts total hospital healthcare costs and costs related to specialist visits, emergency department visits and hospitalization in older adults. METHODS: Concurrent cohort study in Albacete City, Spain. The study sample included 827 subjects aged 70 and over from the FRADEA Study...
May 27, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28592248/impact-of-poor-muscle-strength-on-clinical-and-service-outcomes-of-older-people-during-both-acute-illness-and-after-recovery
#19
Salah Gariballa, Awad Alessa
BACKGROUND: Although Low muscle strength is an important predictor of functional decline in older people, however information on its impact on clinical and service outcomes in acute care settings is still lacking. The aim of this study is to measure the impact of low muscle strength on clinical and service outcomes in older adults during both acute illness and recovery. METHODS: Randomly selected 432 hospitalised older patients had their clinical characteristics and nutritional status assessed within 72 h of admission, at 6 weeks and at 6 months...
June 7, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28587514/pre-hospital-oily-chloramphenicol-treatment-in-meningitis-outbreaks-in-low-resources-environments
#20
Enrico Rino Bregani, Matilde Conti, Caterina Valcarenghi
Bacterial meningitis is an important cause of death and disability in sub-Saharan Africa and, with pre-treatment in peripheral health centres, the poorest populations could avoid early death, especially if they live far from hospital. During the 2001 meningitis epidemic in south Chad, Moyen Chari sanitary district peripheral health centres were equipped with oily chloramphenicol (CAP) to administer before hospital referral in suspected cases of meningitis. Eighty-six patients treated with CAP in whom the diagnosis was definitively confirmed subsequently in hospital were compared with patients receiving CAP at hospital admission during the same period...
January 1, 2017: Tropical Doctor
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