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https://www.readbyqxmd.com/read/28424063/clinical-and-cost-effectiveness-analysis-of-early-detection-of-patients-at-nutrition-risk-during-their-hospital-stay-through-the-new-screening-method-cipa-a-study-protocol
#1
José Pablo Suárez-Llanos, Néstor Benítez-Brito, Laura Vallejo-Torres, Irina Delgado-Brito, Adriá Rosat-Rodrigo, Carolina Hernández-Carballo, Yolanda Ramallo-Fariña, Francisca Pereyra-García-Castro, Juan Carlos-Romero, Nieves Felipe-Pérez, Jennifer García-Niebla, Eduardo Mauricio Calderón-Ledezma, Teresa de Jesús González-Melián, Ignacio Llorente-Gómez de Segura, Manuel Ángel Barrera-Gómez
BACKGROUND: Malnutrition is highly prevalent in hospitalized patients and results in a worsened clinical course as well as an increased length of stay, mortality, and costs. Therefore, simple nutrition screening systems, such as CIPA (control of food intake, protein, anthropometry), may be implemented to facilitate the patient's recovery process. The aim of this study is to evaluate the effectiveness and cost-effectiveness of implementing such screening tool in a tertiary hospital, consistent with the lack of similar, published studies on any hospital nutrition screening system...
April 20, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28419948/genetic-generalized-epilepsy-in-three-siblings-with-8q21-13-q22-2-duplication
#2
Arezoo Rezazadeh, Felippe Borlot, Hanna Faghfoury, Danielle M Andrade
PURPOSE: Duplication of chromosome region 8q21-q22 is a rare copy number variant that has been previously reported in a limited number of patients. Although some of these patients had seizures, their electroclinical syndrome has not been described in detail. The aim of this study was to provide further insight into the specific epilepsy syndrome associated with 8q21.13-q22.2 duplication. METHOD: We describe 3 siblings with trisomy of 8q21.13-q22.2 who exhibited intellectual disability, facial dysmorphism and seizures...
April 11, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28419573/impella-2-5-initiated-prior-to-unprotected-left-main-pci-in-acute-myocardial-infarction-complicated-by-cardiogenic-shock-improves-early-survival
#3
Perwaiz M Meraj, Rajkumar Doshi, Theodore Schreiber, Brijeshwar Maini, William W O'Neill
OBJECTIVES: To assess post-procedural outcomes when Impella 2.5 percutaneous left ventricular assist device (pLVAD) support is initiated either prior to or after percutaneous coronary intervention (PCI) on unprotected left main coronary artery (ULMCA) culprit lesion in the context of acute myocardial infarction cardiogenic shock (AMICS). BACKGROUND: Initiation of Impella 2.5 pLVAD prior to PCI is associated with significant survival benefit in the setting of AMICS...
April 17, 2017: Journal of Interventional Cardiology
https://www.readbyqxmd.com/read/28414666/just-a-puff-of-smoke
#4
A Leonard
CASE: A 44 year old woman with a history of stroke s/p aneurysm clipping, seizure, and substance abuse was brought to the hospital after a family member received a call from her friend saying she was acting unusual and may have had a seizure while hanging out on the street. At her baseline, she needed modest assistance in daily activities after her CVA and conversed without issue. Her mother died of a stroke. On exam the patient was afebrile, normotensive with mild tachycardia to 110...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28414540/the-future-of-community-nursing-hospital-in-the-home
#5
Gerry Lee, Nicola Pickstone, Jose Facultad, Karen Titchener
With an increasing ageing population who often have multiple long-term conditions, there is a growing need to provide an alternative type of care to the traditional hospital-based model. 'Hospital in the Home' is a model that provides integrated care for patients in their home. The @home service was established in 2013 by Guy's and St Thomas' NHS Foundation Trust. The service provides health care in patients' home, supporting early discharge from hospital as well as preventing avoidable admissions and readmissions saving valuable hospital bed days and reducing length of stay...
April 2, 2017: British Journal of Community Nursing
https://www.readbyqxmd.com/read/28414164/a-pre-hospital-extracorporeal-cardio-pulmonary-resuscitation-ecpr-strategy-for-treatment-of-refractory-out-hospital-cardiac-arrest-an-observational-study-and-propensity-analysis
#6
Lionel Lamhaut, Alice Hutin, Etienne Puymirat, Jérome Jouan, Jean-Herlé Raphalen, Romain Jouffroy, Murielle Jaffry, Christelle Dagron, Kim An, Florence Dumas, Eloi Marijon, Wulfran Bougouin, Jean-Pierre Tourtier, Frédéric Baud, Xavier Jouven, Nicolas Danchin, Christian Spaulding, Pierre Carli
BACKGROUND: Out of hospital cardiac arrest (OHCA) mortality rates remain very high with poor neurological outcome in survivors. Extracorporeal cardiopulmonary resuscitation (ECPR) is one of the treatments of refractory OHCA. This study used data from the mobile intensive care unit (MOICU) as part of the emergency medical system of Paris, and included all consecutive patients treated with ECPR (including pre-hospital ECPR) from 2011 to 2015 for the treatment of refractory OHCA, comparing two historical ECPR management strategies...
April 14, 2017: Resuscitation
https://www.readbyqxmd.com/read/28412132/pre-existing-psychiatric-disorder-in-the-burn-patient-is-associated-with-worse-outcomes
#7
Alexandra Hudson, Sarah Al Youha, Osama A Samargandi, Justin Paletz
OBJECTIVE: To compare patient and burn characteristics between patients who had a pre-existing psychiatric diagnosis and patients who did not in a Burn Unit at an academic hospital. BACKGROUND: Psychosocial issues are common in patients recovering from a burn; however, little is known regarding hospital course and discharge outcomes in patients with a pre-existing psychiatric diagnosis presenting with a burn. Baseline medical comorbidities of burn patients have been shown to be a significant risk for in-hospital mortality...
April 12, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/28410318/characteristics-and-outcome-of-patients-after-allogeneic-hematopoietic-stem-cell-transplantation-treated-with-extracorporeal-membrane-oxygenation-for-acute-respiratory-distress-syndrome
#8
Philipp Wohlfarth, Gernot Beutel, Pia Lebiedz, Hans-Joachim Stemmler, Thomas Staudinger, Matthieu Schmidt, Matthias Kochanek, Tobias Liebregts, Fabio Silvio Taccone, Elie Azoulay, Alexandre Demoule, Stefan Kluge, Morten Svalebjørg, Catherina Lueck, Johanna Tischer, Alain Combes, Boris Böll, Werner Rabitsch, Peter Schellongowski
OBJECTIVES: The acute respiratory distress syndrome is a frequent condition following allogeneic hematopoietic stem cell transplantation. Extracorporeal membrane oxygenation may serve as rescue therapy in refractory acute respiratory distress syndrome but has not been assessed in allogeneic hematopoietic stem cell transplantation recipients. DESIGN: Multicenter, retrospective, observational study. SETTING: ICUs in 12 European tertiary care centers (Austria, Germany, France, and Belgium)...
May 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28390471/effect-of-post-hospital-discharge-telephonic-intervention-on-hospital-readmissions-in-a-privately-insured-population-in-australia
#9
G Brent Hamar, Carter Coberley, James E Pope, Andrew Cottrill, Scott Verrall, Shaun Larkin, Elizabeth Y Rula
Objective The aim of the present study was to evaluate the effect of telephone support after hospital discharge to reduce early hospital readmission among members of the disease management program My Health Guardian (MHG) offered by the Hospitals Contribution Fund of Australia (HCF).Methods A quasi-experimental retrospective design compared 28-day readmissions of patients with chronic disease between two groups: (1) a treatment group, consisting of MHG program members who participated in a hospital discharge (HODI) call; and (2) a comparison group of non-participating MHG members...
April 10, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28382213/integrated-services-and-early-intervention-in-the-vocational-rehabilitation-of-people-with-spinal-cord-injuries
#10
Julia Bloom, Pat Dorsett, Vanette McLennan
INTRODUCTION: The design was a narrative review. The objective of the study was to investigate the potential for early vocational rehabilitation (VR) interventions for people with spinal cord injury (SCI) in overcoming barriers in returning to work, and to pinpoint factors contributing to effectiveness in early VR intervention for this population. The setting was at Queensland, Australia. MATERIALS AND METHODS: Synthesis of the findings of a literature search of online databases ProQuest and CINAHL, using keywords relating to the employment situation and VR of people with SCI...
2017: Spinal Cord Series and Cases
https://www.readbyqxmd.com/read/28380706/practical-care-support-during-the-early-recovery-period-after-acute-coronary-syndrome
#11
Alexandra M Hajduk, Jacquelyn E Hyde, Molly E Waring, Darleen M Lessard, David D McManus, Elizabeth B Fauth, Stephenie C Lemon, Jane S Saczynski
OBJECTIVE: To describe the prevalence and predictors of receipt of practical support among acute coronary syndrome (ACS) survivors during the early post-discharge period. METHOD: 406 ACS patients were interviewed about receipt of practical (instrumental and informational) support during the week after discharge. Demographic, clinical, functional, and psychosocial predictors of instrumental and informational practical support were examined. RESULTS: 81% of participants reported receiving practical support during the early post-discharge period: 75% reported receipt of instrumental support and 51% reported receipt of informational support...
December 1, 2016: Journal of Applied Gerontology: the Official Journal of the Southern Gerontological Society
https://www.readbyqxmd.com/read/28378007/do-shorter-lengths-of-stay-increase-readmissions-after-total-joint-replacements
#12
Udai S Sibia, Kip A Waite, Maura A Callanan, Adrian E Park, Paul J King, James H MacDonald
BACKGROUND: Enhanced recovery after surgery protocols for total joint replacements (TJRs) emphasize early discharge, yet the impact on readmissions is not well documented. We evaluate the impact of a one-day length of stay (LOS) discharge protocol on readmissions. METHODS: We conducted a retrospective review of all primary TJRs (hip and knee) from April 2014 to March 2015. Patients who had adequate support to be discharged home were categorized into 2 groups, 1-day (n = 174) vs 2-day (n = 285) LOS groups...
March 2017: Arthroplasty Today
https://www.readbyqxmd.com/read/28375046/delirium-assessed-by-memorial-delirium-assessment-scale-in-advanced-cancer-patients-admitted-to-an-acute-palliative-supportive-care-unit
#13
Sebastiano Mercadante, Claudio Adile, Patrizia Ferrera, Andrea Cortegiani, Alessandra Casuccio
BACKGROUND: Delirium is often unrecognized in cancer patients. The aim of this study was to investigate the prevalence of delirium assessed by Memorial Delirium Assessment Scale (MDAS), and possible associated factors associated on admission to an acute palliative/supportive care unit (ASPCU). The secondary outcome was to assess changes in MDAS and symptom burden at time of discharge. METHODS: A consecutive sample of advanced cancer patients who were admitted to an ASPCU was prospectively assessed for a period of 10 months...
April 4, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28366923/effectiveness-safety-and-tolerability-of-cyclosporine-versus-supportive-treatment-in-stevens-johnson-syndrome-toxic-epidermal-necrolysis-a-record-based-study
#14
Swosti Mohanty, Anupam Das, Anupama Ghosh, Amrita Sil, Ramesh Chandra Gharami, Debabrata Bandyopadhyay, Nilay Kanti Das
BACKGROUND: Toxic epidermal necrolysis and Stevens-Johnson syndrome comprise life-threatening, drug-induced mucocutaneous disease spectrum. Interest in cyclosporine, a calcineurin inhibitor that can block the function of T-cells, has increased with the discovery of the importance of granulysin in apoptosis in toxic epidermal necrolysis. In our hospital, cyclosporine is given to Stevens-Johnson syndrome/toxic epidermal necrolysis patients as an adjunctive therapy. AIMS: This study is an observational, record-based study comparing the effectiveness and safety of patients receiving cyclosporine versus only supportive therapy...
March 31, 2017: Indian Journal of Dermatology, Venereology and Leprology
https://www.readbyqxmd.com/read/28365632/stroke-unit-care-inpatient-rehabilitation-and-early-supported-discharge
#15
Helen Rodgers, Chris Price
Stroke units reduce death and disability through the provision of specialist multidisciplinary care for diagnosis, emergency treatments, normalisation of homeostasis, prevention of complications, rehabilitation and secondary prevention. All stroke patients can benefit from provision of high-quality basic medical care and some need high impact specific treatments, such as thrombolysis, that are often time dependent. A standard patient pathway should include assessment of neurological impairment, vascular risk factors, swallowing, fluid balance and nutrition, cognitive function, communication, mood disorders, continence, activities of daily living and rehabilitation goals...
April 2017: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/28363627/evaluation-of-a-nurse-initiated-acute-gastroenteritis-pathway-in-the-pediatric-emergency-department
#16
Rebecca A Carson, Shawna S Mudd, P Jamil Madati
Acute gastroenteritis (AGE) is a common illness treated in the emergency department. Delays in initiating rehydration for children with mild or moderate dehydration from AGE can lead to prolonged ED visits and increased resource utilization that do not provide prognostic value or support family-centered care. The purpose of this quality improvement project was to promote early oral rehydration therapy (ORT) for persons with AGE in an attempt to reduce unnecessary resource utilization and length of stay (LOS)...
March 28, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28361743/the-role-of-nutritional-assessment-and-early-enteral-nutrition-for-combined-pancreas-and-kidney-transplant-candidates
#17
Sally Finlay, Argiris Asderakis, Adel Ilham, Doruk Elker, Dawn Chapman, Elijah Ablorsu
BACKGROUND: Early post-operative enteral nutrition is an important part of perioperative management and is strongly supported by ESPEN Guidelines. However, there is limited evidence into the use of Early Enteral Nutrition (EEN) after combined Pancreas and Kidney Transplantation (PKT). We know malnutrition in type-1 diabetics with end stage renal failure (ESRF) is a common problem and a significant risk factor. Therefore, we introduced EEN in our patients. METHOD: We monitored and recorded nutritional data on 29 PKT recipients who underwent transplantation between Oct 2007 and Jan 2010 without a nutritional assessment or EEN [Monitored Group (MG)] and on 30 PKT recipients between Feb 2010 and Dec 2013 who received a nutritional assessment and EEN (Naso-jejunal feed or oral intake with supplementation, according to their nutritional status) [Fed Group (FG)]...
February 2017: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28361055/changes-in-circulating-monocyte-subsets-cd16-expression-and-neutrophil-to-lymphocyte-ratio-observed-in-patients-undergoing-cardiac-surgery
#18
Kareem Gawdat, Stephanie Legere, Chloe Wong, Tanya Myers, Jean Sylvia Marshall, Ansar Hassan, Keith R Brunt, Petra C Kienesberger, Thomas Pulinilkunnil, Jean-Francois Legare
BACKGROUND: The characteristics of circulating inflammatory cells (leukocytes) in patients undergoing heart surgery remains poorly understood. Recently, neutrophil-to-lymphocyte ratio (NLR) and specific monocyte subsets (based on CD14/CD16 expression) have been suggested as markers of inflammation and predictors of outcomes. The present study aims to characterize the influence cardiac surgery with cardiopulmonary bypass has on specific circulating leukocytes. METHODS: All enrolled patients had blood samples taken pre- (0 days), early post- (5 days), and late post- (90 days) surgery...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/28360292/comment-on-outburst-flood-at-1920-bce-supports-historicity-of-china-s-great-flood-and-the-xia-dynasty
#19
Jian-Chiu Han
By analyzing the data and methodology of Wu et al (Reports, 5 August 2016, p. 579), I find that their conclusions about the scale of the dammed lake, the dating of the lake, and the peak discharge at the point of dam failure and at the Lajia site cannot be validated. The conjecture of the supposed Great Flood and its impact on the formation of the early Chinese dynasty is not substantiated.
March 31, 2017: Science
https://www.readbyqxmd.com/read/28356750/early-discharge-compared-with-ordinary-discharge-after-percutaneous-coronary-intervention-a-systematic-review-and-meta-analysis-of-safety-and-cost
#20
REVIEW
Michael Abdelnoor, Jack Gunnar Andersen, Harald Arnesen, Odd Johansen
AIM: We aimed to summarize the pooled effect of early discharge compared with ordinary discharge after percutaneous coronary intervention (PCI) on the composite endpoint of re-infarction, revascularization, stroke, death, and incidence of rehospitalization. We also aimed to compare costs for the two strategies. METHODS: The study was a systematic review and a meta-analysis of 12 randomized controlled trials including 2962 patients, followed by trial sequential analysis...
2017: Vascular Health and Risk Management
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