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https://www.readbyqxmd.com/read/29342264/effect-of-continuous-glucose-monitoring-on-glycemic-control-acute-admissions-and-quality-of-life-a-real-world-study
#1
Sara Charleer, Chantal Mathieu, Frank Nobels, Christophe De Block, Regis P Radermecker, Michel P Hermans, Youri Taes, Chris Vercammen, Guy T'Sjoen, Laurent Crenier, Steffen Fieuws, Bart Keymeulen, Pieter Gillard
Context: Randomized controlled trials evaluating real-time continuous glucose monitoring (RT-CGM) patients with type 1 diabetes (T1D) show improved glycemic control, but limited data are available on real-world use. Objective: To assess impact of RT-CGM in real-world settings on glycemic control, hospital admissions, work absenteeism and quality of life (QOL). Design: Prospective, observational, multicenter, cohort study. Participants: Five hundred fifteen adults with T1D on continuous subcutaneous insulin infusion (CSII) therapy starting in the Belgian RT-CGM reimbursement program...
January 12, 2018: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/29342203/biological-pathways-underlying-the-association-of-red-cell-distribution-width-and-adverse-clinical-outcome-results-of-a-prospective-cohort-study
#2
Giedre Zurauskaite, Marc Meier, Alaadin Voegeli, Daniel Koch, Sebastian Haubitz, Alexander Kutz, Luca Bernasconi, Andreas Huber, Mario Bargetzi, Beat Mueller, Philipp Schuetz
BACKGROUND: Red cell distribution width (RDW) predicts disease outcome in several patient populations, but its prognostic value in addition to other disease parameters in unselected medical inpatients remains unclear. Our aim was to investigate the association of admission RDW levels and mortality adjusted for several disease pathways in unselected medical patients from a previous multicenter study. METHODS: We included consecutive adult, medical patients at the time point of hospital admission through the emergency department into this observational, cohort study...
2018: PloS One
https://www.readbyqxmd.com/read/29342019/hot-spotting-as-a-strategy-to-identify-high-cost-surgical-populations
#3
Sarah P Shubeck, Jyothi R Thumma, Justin B Dimick, Hari Nathan
OBJECTIVE: The aim of this study was to determine the feasibility of "hot spotting" in elective surgical populations. BACKGROUND: Prospective identification of high-cost patients, known as "hot spotting," is well developed in medical populations, but has not been performed in surgical populations. Population-based management of surgical expenditures requires identification of high-cost surgical patients to allow for effective implementation of cost-saving strategies...
January 16, 2018: Annals of Surgery
https://www.readbyqxmd.com/read/29341967/new-modalities-for-the-administration-of-inhaled-nitric-oxide-in-intensive-care-units-after-cardiac-surgery-or-for-neonatal-indications-a-prospective-observational-study
#4
Philippe Gaudard, Claudio Barbanti, Bertrand Rozec, Philippe Mauriat, Mimoun M'rini, Gilles Cambonie, Jean Michel Liet, Claude Girard, Pierre Louis Leger, Ziad Assaf, Pierre Damas, Gauthier Loron, Laurent Lecourt, Julien Amour, Philippe Pouard
BACKGROUND: Nitric oxide (NO) has a well-known efficacy in pulmonary hypertension (PH), with wide use for 20 years in many countries. The objective of this study was to describe the current use of NO in real life and the gap with the guidelines. METHODS: This is a multicenter, prospective, observational study on inhaled NO administered through an integrated delivery and monitoring device and indicated for PH according to the market authorizations. The characteristics of NO therapy and ventilation modes were observed...
January 16, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29341938/increased-serum-concentrations-of-soluble-st2-are-associated-with-pulmonary-complications-and-mortality-in-polytraumatized-patients
#5
Thomas Haider, Elisabeth Simader, Philipp Hacker, Hendrik J Ankersmit, Thomas Heinz, Stefan Hajdu, Lukas L Negrin
BACKGROUND: We sought to evaluate the role of soluble ST2 (suppression of tumorigenicity) serum concentrations in polytraumatized patients and its potential role as biomarker for pulmonary complications. METHODS: We included severely injured patients (injury severity score≥16) admitted to our level I trauma center and analyzed serum samples obtained on the day of admission and on day 2. Furthermore, patients with isolated thoracic injury and healthy probands were included and served as control groups...
January 17, 2018: Clinical Chemistry and Laboratory Medicine: CCLM
https://www.readbyqxmd.com/read/29341793/platelet-transfusion-does-not-improve-outcomes-in-patients-with-brain-injury-on-antiplatelet-therapy
#6
Jeremy L Holzmacher, Cassandra Reynolds, Mayur Patel, Patrick Maluso, Seth Holland, Nathaniel Gamsky, Henry Moore, Elizabeth Acquista, Matthew Carrick, Richard Amdur, Heather Hancock, Michael Metzler, Julie Dunn, Babak Sarani
INTRODUCTION: Platelet dysfunction following traumatic brain injury (TBI) is associated with worse outcomes. The efficacy of platelet transfusion to reverse antiplatelet medication (APM) remains unknown. Thrombelastography platelet mapping (TEG-PM) assesses platelet function. We hypothesize that platelet transfusion can reverse the effects of APM but does not improve outcomes following TBI. METHODS: An observational study at six US trauma centres was performed. Adult patients on APM with CT evident TBI after blunt injury were enrolled...
January 17, 2018: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29341466/effects-of-intravenous-home-dobutamine-in-palliative-end-stage-heart-failure-on-quality-of-life-heart-failure-hospitalization-and-cost-expenditure
#7
Pieter Martens, Jan Vercammen, Wendy Ceyssens, Linda Jacobs, Evert Luwel, Herwig Van Aerde, Peter Potargent, Monique Renaers, Matthias Dupont, Wilfried Mullens
AIMS: In patients with palliative end-stage heart failure, interventions that could provide symptomatic relief and prevent hospital admissions are important. Ambulatory continuous intravenous inotropes have been advocated by guidelines for such a purpose. We sought to determine the effect of intravenous dobutamine on symptomatic status, hospital stay, mortality, and cost expenditure. METHODS AND RESULTS: All consecutive end-stage heart failure patients not amenable for advanced therapies and discharged with continuous intravenous home dobutamine from a single tertiary centre between April 2011 and January 2017 were retrospectively analysed...
January 17, 2018: ESC Heart Failure
https://www.readbyqxmd.com/read/29341456/iron-pill-aspiration-cytologic-and-histologic-findings-of-a-potential-life-threatening-airway-injury-a-case-report-and-literature-review
#8
Vanessa Henriques, Diogo Costa Santos, Graça Lérias, Lucília Cáceres Monteiro
Iron pill-induced injury of bronchial mucosa is a complication following accidental aspiration of an iron tablet. Oral iron supplementation is a common therapy, particularly among advanced-age patients, who are more prone to aspiration. However, iron pill aspiration has been rarely reported in the literature, usually under the format of short case reports, with only 32 cases published in the literature. The cytologic features suspicious for this rare but potentially lethal entity have been seldom described...
January 16, 2018: Diagnostic Cytopathology
https://www.readbyqxmd.com/read/29341345/increase-in-neutrophil-after-r-tpa-thrombolysis-predicts-poor-functional-outcome-of-ischemic-stroke-a-longitudinal-study
#9
Jijun Shi, Hao Peng, Shoujiang You, Yuanyuan Liu, Jiaping Xu, Yingying Xu, Huihui Liu, Rongfang Shi, Yongjun Cao, Chun-Feng Liu
BACKGROUND: Neutrophil, a pivotal immune responder to ischemic brain insult, has been involved in neuroplasticity and increases after stroke. r-tPA, a promising treatment improving neuroplasticity, promotes neutrophil degranulation. However, the dynamic profile of neutrophil after r-tPA treatment and its effect on neurological recovery after stroke is not well studied. METHODS: We measured cell counts of neutrophil, lymphocyte, and their ratio (NLR) on admission and 24 hours after r-tPA infusion in 372 consecutively recruited acute ischemic stroke patients (mean age 64 years)...
January 17, 2018: European Journal of Neurology: the Official Journal of the European Federation of Neurological Societies
https://www.readbyqxmd.com/read/29341336/identification-of-perioperative-pulmonary-aspiration-in-children-using-quality-assurance-and-hospital-administrative-billing-data
#10
Lisa Eisler, Grace Huang, Ka-Eun M Lee, Jennifer A Busse, Ming Sun, Albert Y Lin, Lena S Sun, Caleb Ing
BACKGROUND: Perioperative aspiration is a rare but potentially devastating complication, occurring in 1-10 per 10 000 anesthetics based on studies of quality assurance databases. Quality assurance reporting is known to underestimate the incidence of adverse outcomes, but few large studies use supplementary data sources. This study aims to identify the incidence of and risk factors for perioperative aspiration in children using quality assurance data supplemented by administrative billing records, and to examine the utility of billing data as a supplementary data source...
January 17, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29341176/different-responses-of-supraventricular-tachycardia-with-2-1-av-block-to-consecutive-premature-ventricular-contractions
#11
Svetoslav Kurtev, Cristina Valduva, László Sághy, Robert Pap
A 52-year old female was admitted with complaints of palpitations for two years. The transthoracic echocardiography and electrocardiogram were both normal at the time of admission. We performed an electrophysiology study where the baseline intervals were in normal range. During burst atrial pacing we observed HV prolongation (HV = 80 ms) and infra-Hisian block. This article is protected by copyright. All rights reserved.
January 16, 2018: Pacing and Clinical Electrophysiology: PACE
https://www.readbyqxmd.com/read/29341068/analysis-of-hypo-and-hypermagnesemia-in-an-intensive-care-unit-cohort
#12
M Broman, F Hansson, B Klarin
INTRODUCTION: The aim of this study was to evaluate if magnesium deviations correlate with higher 180 day overall mortality or increased morbidity, compared to controls. METHODS: We conducted a retrospective study on 5369 patients with 22,003 magnesium values treated at the Adult Intensive Care Unit at Skåne University Hospital, Lund, Sweden during 2006-2014. The patients were retrospectively divided into a control group with only normal magnesium values 0.7-1...
January 16, 2018: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29340944/persons-with-disability-social-deprivation-and-an-emergency-medical-admission
#13
Seán Cournane, Richard Conway, Declan Byrne, Deirdre O'Riordan, Bernard Silke
BACKGROUND: The community level of disability and social deprivation may result in an emergency hospitalisation; we have examined the annual admission incidence rate for emergency medical conditions in relation to the community prevalence of such factors. METHODS: All emergency medical admissions (96,305 episodes in 50,612 patients) within the institution's catchment area were examined between 2002 and 2016. The frequency of disability, level of full-time carers and unemployment for the 74 electoral divisions of the catchment area was regressed against admission rates; incidence rate ratios (IRR) were calculated using truncated Poisson regression...
January 16, 2018: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/29340940/characterizing-potentially-preventable-admissions-a-mixed-methods-study-of-rates-associated-factors-outcomes-and-physician-decision-making
#14
Lisa M Daniels, Atsushi Sorita, Deanne T Kashiwagi, Masashi Okubo, Evan Small, Eric C Polley, Adam P Sawatsky
BACKGROUND: Potentially preventable admissions are a target for healthcare cost containment. OBJECTIVE: To identify rates of, characterize associations with, and explore physician decision-making around potentially preventable admissions. DESIGN: A comparative cohort study was used to determine rates of potentially preventable admissions and to identify associated factors and patient outcomes. A qualitative case study was used to explore physicians' clinical decision-making...
January 16, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29340918/validation-of-aast-egs-grade-for-acute-pancreatitis
#15
Moustafa Younis, Matthew Hernandez, Mohamed Ray-Zack, Nadeem N Haddad, Asad Choudhry, Pooja Reddy, Martin D Zielinski
BACKGROUND: The AAST recently developed an emergency general surgery (EGS) disease grading system to measure anatomic severity. We aimed to validate this grading system for acute pancreatitis and compare cross sectional imaging-based AAST EGS grade and compare with several clinical prediction models. We hypothesize that increased AAST EGS grade would be associated with important physiological and clinical outcomes and is comparable to other severity grading methods. METHODS: Single institution retrospective review of adult patients admitted with acute pancreatitis during 10/2014-1/2016 was performed...
January 16, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29340912/predictors-of-hypoglycemia-in-hospitalized-patients-with-diabetes-mellitus
#16
Amit Akirov, Oren Amitai, Hiba Masri-Iraqi, Talia Diker-Cohen, Tzipora Shochat, Yoav Eizenberg, Ilan Shimon
Hypoglycemia is common among hospitalized patients with diabetes mellitus (DM), and is associated with increased morbidity and mortality. Identify pre-admission risk factors associated with in-hospital hypoglycemia. Historical prospectively collected data of adult DM patients hospitalized to medical wards between 2011 and 2013. Hypoglycemia and serious hypoglycemia were defined as at least one blood glucose measurement ≤ 70 and < 54 mg/dl, respectively, during hospitalization. The primary outcome was in-hospital hypoglycemia...
January 16, 2018: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/29340892/a-summer-prematriculation-program-to-help-students-succeed-in-medical-school
#17
Stephen D Schneid, April Apperson, Nora Laiken, Jess Mandel, Carolyn J Kelly, Katharina Brandl
Medical schools with a diverse student body face the challenge of ensuring that all students succeed academically. Many medical schools have implemented prematriculation programs to prepare students from diverse backgrounds; however, evidence on their impact is largely lacking. In this study, we analyzed participants' demographics as well as the impact of the prematriculation program on Year 1 performance. Predictive validity of the program was assessed and compared to other traditional predictors, including grade point average (GPA) and Medical College Admission Test (MCAT) scores and subscores...
January 16, 2018: Advances in Health Sciences Education: Theory and Practice
https://www.readbyqxmd.com/read/29340855/the-relationship-between-target-joints-and-direct-resource-use-in-severe-haemophilia
#18
Jamie O'Hara, Shaun Walsh, Charlotte Camp, Giuseppe Mazza, Liz Carroll, Christina Hoxer, Lars Wilkinson
OBJECTIVES: Target joints are a common complication of severe haemophilia. While factor replacement therapy constitutes the majority of costs in haemophilia, the relationship between target joints and non drug-related direct costs (NDDCs) has not been studied. METHODS: Data on haemophilia patients without inhibitors was drawn from the 'Cost of Haemophilia across Europe - a Socioeconomic Survey' (CHESS) study, a cost assessment in severe haemophilia A and B across five European countries (France, Germany, Italy, Spain, and the United Kingdom) in which 139 haemophilia specialists provided demographic and clinical information for 1285 adult patients...
January 16, 2018: Health Economics Review
https://www.readbyqxmd.com/read/29340820/the-development-and-validation-of-a-scoring-tool-to-predict-the-operative-duration-of-elective-laparoscopic-cholecystectomy
#19
Reshma Bharamgoudar, Aniket Sonsale, James Hodson, Ewen Griffiths
BACKGROUND: The ability to accurately predict operative duration has the potential to optimise theatre efficiency and utilisation, thus reducing costs and increasing staff and patient satisfaction. With laparoscopic cholecystectomy being one of the most commonly performed procedures worldwide, a tool to predict operative duration could be extremely beneficial to healthcare organisations. METHODS: Data collected from the CholeS study on patients undergoing cholecystectomy in UK and Irish hospitals between 04/2014 and 05/2014 were used to study operative duration...
January 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29340768/the-comparison-of-clinical-outcomes-in-patients-with-acute-myocardial-infarction-and-advanced-chronic-kidney-disease-on-chronic-hemodialysis-versus-off-hemodialysis
#20
Naoyuki Akashi, Kenichi Sakakura, Yusuke Watanabe, Masamitsu Noguchi, Yousuke Taniguchi, Kei Yamamoto, Hiroshi Wada, Shin-Ichi Momomura, Hideo Fujita
Acute myocardial infarction (AMI) is more frequently observed in patients with chronic kidney disease (CKD) than in patients without CKD. Initial treatment strategy for AMI includes primary percutaneous coronary intervention (PCI), which requires substantial amount of contrast media. We hypothesized that the clinical outcomes are comparable or worse in patients with AMI and advanced CKD off chronic hemodialysis as compared to patients with AMI and advanced CKD on chronic hemodialysis. The purpose of this study was to compare the clinical outcomes of patients with AMI and advanced CKD on hemodialysis versus off hemodialysis...
January 16, 2018: Heart and Vessels
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