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Early supported discharge

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https://www.readbyqxmd.com/read/28747895/combining-standard-conventional-measures-and-ecological-momentary-assessment-of-depression-anxiety-and-coping-using-smartphone-application-in-minor-stroke-population-a-longitudinal-study-protocol
#1
Camille Vansimaeys, Mathieu Zuber, Benjamin Pitrat, Claire Join-Lambert, Ruben Tamazyan, Wassim Farhat, Catherine Bungener
Context: Stroke has several consequences on survivors' daily life even for those who experience short-lasting neurological symptoms with no functional disability. Depression and anxiety are common psychological disorders occurring after a stroke. They affect long-term outcomes and quality of life but they are difficult to diagnose because of the neurobiological consequences of brain lesions. Current research priority is given to the improvement of the detection and prevention of those post-stroke psychological disorders...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28743315/tight-intra-operative-blood-pressure-control-versus-standard-care-for-patients-undergoing-hip-fracture-repair-hip-fracture-intervention-study-for-prevention-of-hypotension-hip-hop-trial-study-protocol-for-a-randomised-controlled-trial
#2
Iain Keith Moppett, Stuart White, Richard Griffiths, Donal Buggy
BACKGROUND: Hypotension during anaesthesia for hip fracture surgery is common. Recent data suggest that there is an association between the lowest intra-operative blood pressure and mortality, even when adjusted for co-morbidities. This is consistent with data derived from the wider surgical population, where magnitude and duration of hypotension are associated with mortality and peri-operative complications. However, there are no trial to data to support more aggressive blood pressure control...
July 25, 2017: Trials
https://www.readbyqxmd.com/read/28739479/emergency-department-visits-after-lumbar-spine-surgery-are-associated-with-lower-hcahps-scores
#3
Jay M Levin, Robert D Winkelman, Gabriel A Smith, Joseph E Tanenbaum, Roy Xiao, Thomas E Mroz, Michael P Steinmetz
BACKGROUND: Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) surveys are used to assess the quality of the patient experience following an inpatient stay. HCAHPS scores are used to determine reimbursement for hospital systems and incentivize spine surgeons nationwide. There are conflicting data detailing whether early readmission or other post-discharge complications are associated with patient responses on the HCAHPS survey. Currently, the association between post-discharge ED visits and HCAHPS scores following lumbar spine surgery is unknown...
July 21, 2017: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/28738901/stroke-in-a-resource-constrained-hospital-in-madagascar
#4
Pål Sigurd Stenumgård, Miadana Joshua Rakotondranaivo, Olav Sletvold, Turid Follestad, Hanne Ellekjær
BACKGROUND: Stroke is reported as the most frequent cause of in-hospital death in Madagascar. However, no descriptive data on hospitalized stroke patients in the country have been published. In the present study, we sought to investigate the feasibility of collecting data on stroke patients in a resource-constrained hospital in Madagascar. We also aimed to characterize patients hospitalized with stroke. METHODS: We registered socio-demographics, clinical characteristics, and early outcomes of patients admitted for stroke between 23 September 2014 and 3 December 2014...
July 24, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28735032/a-prospective-study-of-breastfeeding-intentions-of-healthy-weight-and-overweight-women-as-predictors-of-breastfeeding-outcomes
#5
Susan J de Jersey, Kimberley Mallan, Justine Forster, Lynne A Daniels
OBJECTIVE: Women with a higher BMI are at increased risk of breastfeeding for a shorter duration, however it is unclear if weight status itself or other factors such as feeding intentions are responsible for early breastfeeding cessation. The aim of this study was determine the influence of maternal pre-pregnancy weight status on infant feeding intentions during pregnancy using a validated scale and assess whether high intentions to exclusively breastfeed measured during pregnancy predicted feeding mode at discharge and at 4 months postpartum in both healthy weight (Hwt) (BMI< 25kg/m(2)) and overweight (Owt)(BMI > 25kg/m(2)) women...
July 5, 2017: Midwifery
https://www.readbyqxmd.com/read/28722784/the-universal-collaborative-dynamic-model-of-specialist-and-advanced-nursing-and-midwifery-practice-a-way-forward
#6
Laserina O'Connor, Mary Casey, Rita Smith, Gerard Michael Fealy, Denise O' Brien, Denise O'Leary, Diarmuid Stokes, Martin S McNamara, Mary Ellen Glasgow, Andrew Cashin
BACKGROUND: There is a sizable body of empirical literature supporting the unique contributions of specialist and advanced practice roles to health care. However, there is very little international evidence to inform the integration of a future model for advanced or specialist practice in the Irish health care system. AIM: The aim of this study was to inform and guide the development of a future model of specialist and advanced nursing and midwifery practice. DESIGN: A qualitative study was conducted to initiate this important area of inquiry...
July 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28709419/the-clinical-and-virological-features-of-the-first-imported-case-causing-mers-cov-outbreak-in-south-korea-2015
#7
Ji Yeon Lee, You-Jin Kim, Eun Hee Chung, Dae-Won Kim, Ina Jeong, Yeonjae Kim, Mi-Ran Yun, Sung Soon Kim, Gayeon Kim, Joon-Sung Joh
BACKGROUND: In 2015, the largest outbreak of Middle East respiratory syndrome coronavirus (MERS-CoV) infection outside the Middle East occurred in South Korea. We summarized the epidemiological, clinical, and laboratory findings of the first Korean case of MERS-CoV and analyzed whole-genome sequences of MERS-CoV derived from the patient. CASE PRESENTATION: A 68-year-old man developed fever and myalgia 7 days after returning to Korea, following a 10-day trip to the Middle East...
July 14, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28707741/randomized-clinical-trial-of-psychological-support-and-sleep-adjuvant-measures-for-postoperative-sleep-disturbance-in-patients-undergoing-oesophagectomy
#8
M Scarpa, E Pinto, E Saraceni, F Cavallin, M Parotto, R Alfieri, M T Nardi, M R Marchi, M Cagol, C Castoro
BACKGROUND: Major surgery such as oesophagectomy requires a postoperative stay in intensive care. Painful stimuli lead to sleep disturbance and impairment in quality of life. The aim of this study was to evaluate the effect of psychological counselling and sleep adjuvant measures on postoperative quality of sleep and quality of life. METHODS: This RCT was performed between January 2013 and October 2015. Patients undergoing oesophagectomy for cancer were randomized into one of four groups receiving: psychological counselling plus sleep adjuvant measures during the ICU stay; psychological counselling alone; sleep adjuvant measures alone during the ICU stay; or standard care...
July 14, 2017: British Journal of Surgery
https://www.readbyqxmd.com/read/28704268/safe-discharge-and-outpatient-investigation-of-ureteric-colic-a-retrospective-analysis
#9
Michael Stewart
BACKGROUND: Computed tomography of the kidneys, ureters and bladder is the recommended imaging modality for suspected urolithiasis. Early scanning is advised in guidelines, but there is limited published evidence to support this recommendation. PATIENTS AND METHODS: In a retrospective study, we reviewed patients managed according to a local guideline. Patients without high-risk features were either imaged during their initial visit (if in the daytime) or discharged for outpatient scans...
July 12, 2017: European Journal of Emergency Medicine: Official Journal of the European Society for Emergency Medicine
https://www.readbyqxmd.com/read/28703869/early-supported-discharge-services-for-people-with-acute-stroke
#10
REVIEW
Peter Langhorne, Satu Baylan
BACKGROUND: People with stroke conventionally receive a substantial part of their rehabilitation in hospital. Services have now been developed that offer people in hospital an early discharge with rehabilitation at home (early supported discharge: ESD). OBJECTIVES: To establish if, in comparison with conventional care, services that offer people in hospital with stroke a policy of early discharge with rehabilitation provided in the community (ESD) can: 1) accelerate return home, 2) provide equivalent or better patient and carer outcomes, 3) be acceptable satisfactory to patients and carers, and 4) have justifiable resource implications use...
July 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28703046/multivessel-versus-culprit-lesion-only-percutaneous-coronary-intervention-in-cardiogenic-shock-complicating-acute-myocardial-infarction-a-systematic-review-and-meta-analysis
#11
Suzanne de Waha, Alexander Jobs, Ingo Eitel, Janine Pöss, Thomas Stiermaier, Roza Meyer-Saraei, Georg Fuernau, Uwe Zeymer, Steffen Desch, Holger Thiele
BACKGROUND: Early revascularisation of the culprit lesion is the therapeutic cornerstone in cardiogenic shock complicating acute myocardial infarction. The optimal management of additional non-culprit lesions is unclear. This systematic review and meta-analysis aims to summarise current evidence on the comparison of immediate multivessel percutaneous coronary intervention (MV-PCI) or culprit lesion only PCI with possible staged revascularisation (C-PCI) in patients with cardiogenic shock complicating acute myocardial infarction...
July 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28699602/importance-of-target-calorie-intake-in-hospitalized-patients
#12
Ferda Akbay Harmandar, Ismail Gömceli, Başak Oğuz Yolcular, Ayhan Hilmi Çekin
BACKGROUND/AIMS: To evaluate the feasibility and clinical outcome of a nutritional algorithm based on target calorie intake commenced as enteral nutrition (EN) alone or in combination with supplemental parenteral nutrition (SPN) among hospitalized patients. MATERIALS AND METHODS: In total, 301 hospitalized patients who were provided with nutritional support, including EN (n=125) or EN+SPN (n=176), due to various medical conditions during their hospitalization were included in this study conducted at Antalya Training and Research Hospital...
July 2017: Turkish Journal of Gastroenterology: the Official Journal of Turkish Society of Gastroenterology
https://www.readbyqxmd.com/read/28694620/nonalcoholic-wernicke-s-encephalopathy-a-retrospective-study-from-a-tertiary-care-center-in-northern-india
#13
Irfan Ahmad Shah, Ravouf Parvaiz Asimi, Yuman Kawoos, Maqbool Wani, Tahir Saleem, Waqas Nabi Baba
OBJECTIVE: The objective of this study was to describe the demographic features, clinical presentation, and management and outcome of fifty cases of nonalcoholic Wernicke's encephalopathy from a tertiary care hospital of a region with reported incidence of thiamine deficiency disorders. MATERIALS AND METHODS: In a retrospective study, fifty adult cases of Wernicke's encephalopathy were analyzed. The diagnosis of Wernicke's encephalopathy was made according to the European federation of neurological societies guidelines 2010...
July 2017: Journal of Neurosciences in Rural Practice
https://www.readbyqxmd.com/read/28682938/improving-patient-selection-for-refractory-out-of-hospital-cardiac-arrest-treated-with-extracorporeal-life-support
#14
Tahar Chouihed, Antoine Kimmoun, Adrien Lauvray, Francois-Xavier Laithier, Deborah Jaeger, Simon Lemoine, Juan Pablo Maureira, Lionel Nace, Kevin Duarte, Stéphane Albizzati, Nicolas Girerd, Bruno Levy
BACKGROUND: Despite recent management improvement, including Extra-Corporeal Life Support (ECLS), refractory out-of-hospital cardiac arrest (ROHCA) survival remains dramatically low. METHODS: We assessed an innovative strategy (Out of hoSpital Cardiac ARrest-ExtraCorporeal Life Support - "OSCAR-ECLS") to optimize access to ECLS of ROHCA patients and reduce the delay between recognition and ECLS implantation. METHODS: This study, conducted in a tertiary teaching hospital, compared the survival and delay times of ROHCA patients treated by ECLS before and after OSCAR-ECLS implementation...
July 4, 2017: Shock
https://www.readbyqxmd.com/read/28659194/out-of-hospital-cardio-pulmonary-arrest-is-there-a-role-for-the-primary-healthcare-teams
#15
Shlomo Vinker
Out of hospital cardiac arrest (OHCA) remains a major cause of morbidity and mortality. The survival rates are poor and even more frustrating are the rates of neurologically favorable outcomes at hospital discharge. In a recent IJHPR article, Einav et al. concluded that many primary care clinics are underequipped and the physicians underprepared to initiate life-saving services. The chance of having an OHCA in a primary care clinic is very low. But although the impact is small, primary care teams as well as other out-of-hospital healthcare personal should be familiar with the telephone number for summoning emergency medical services (EMS), be aware of the location of the defibrillator in their clinic, and know how to use it...
June 28, 2017: Israel Journal of Health Policy Research
https://www.readbyqxmd.com/read/28658159/outcomes-of-primary-gastric-transposition-for-long-gap-esophageal-atresia-in-neonates
#16
Zhandong Zeng, Fengli Liu, Juan Ma, Yun Fang, Hongwei Zhang
BACKGROUND: Gastric transposition is a relatively novel method of esophageal replacement. The purpose of this retrospective study was to assess the outcomes of long-gap esophageal atresia (LGEA) treated with esophageal replacement using primary gastric transposition in neonates. METHODS: Between March 2008 and May 2015, 14 newborns with LGEA were treated in our hospital. They were all found to have gaps of over 3 cm at the time of the surgery and were diagnosed with LGEA...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28655625/impact-of-city-police-layperson-education-and-equipment-with-automatic-external-defibrillators-on-patient-outcome-after-out-of-hospital-cardiac-arrest
#17
Philipp Stein, Gabriela H Spahn, Stefan Müller, Andreas Zollinger, Werner Baulig, Martin Brüesch, Burkhardt Seifert, Donat R Spahn
INTRODUCTION: Out of hospital cardiac arrest (OHCA) occurs frequently and the outcome is often dismal. Early defibrillation saves lives and brain function in OHCA. The Zurich city police (STAPO) forces were instructed and equipped to provide basic life support (BLS) and to use an AED in 2009. METHODS: Retrospective observational study comparing period 1 (P1) 2004-2009 before equipping and training of the STAPO and period 2 (P2) 2010-2015 after the implementation...
June 24, 2017: Resuscitation
https://www.readbyqxmd.com/read/28652718/an-analysis-of-the-economic-and-patient-outcome-impact-of-an-integrated-copd-service-in-east-london
#18
Anna Garner, Matthew Hodson, Georgios Ketsetzis, Laurence Pulle, Janelle Yorke, Angshu Bhowmik
Exacerbations of COPD carry a huge burden of morbidity and a significant economic impact. It has been shown that home care may be useful for exacerbations of COPD. This article presents a review of an integrated COPD service in east London. Hospital Episode Statistics, Public Health Mortality Files and clinical data were used to analyze differences in health care usage and COPD patient outcomes, including COPD assessment test (CAT) scores for a subsample, before and after the introduction of the integrated service...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28649575/ecmo-in-major-burn-patients-feasibility-and-considerations-when-multiple-modes-of-mechanical-ventilation-fail
#19
Jason D Kennedy, Wesley Thayer, Reuben Beuno, Kelly Kohorst, Avinash B Kumar
BACKGROUND: We report two cases of acute respiratory distress syndrome in burn patients who were successfully managed with good outcomes with extra corporeal membrane oxygenation (ECMO) after failing multiple conventional modes of ventilation, and review the relevant literature. CASE PRESENTATION: The two patients were a 39-year-old male and 53-year-old male with modified Baux Scores of 79 and 78, respectively, with no known inhalation injury. After the initial modified Parkland-based fluid resuscitation and partial escharotomy, both patients developed worsening hypoxemia and acute respiratory distress syndrome...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28647272/outcomes-of-preterm-infants-following-discussions-about-withdrawal-or-withholding-of-life-support
#20
Jennifer James, David Munson, Sara B DeMauro, John C Langer, April R Dworetz, Girija Natarajan, Margarita Bidegain, Christine A Fortney, Ruth Seabrook, Betty R Vohr, Jon E Tyson, Edward F Bell, Brenda B Poindexter, Seetha Shankaran, Rosemary D Higgins, Abhik Das, Barbara J Stoll, Haresh Kirpalani
OBJECTIVES: To describe the frequency of postnatal discussions about withdrawal or withholding of life-sustaining therapy (WWLST), ensuing WWLST, and outcomes of infants surviving such discussions. We hypothesized that such survivors have poor outcomes. STUDY DESIGN: This retrospective review included registry data from 18 centers of the National Institute of Child Health and Human Development Neonatal Research Network. Infants born at 22-28 weeks of gestation who survived >12 hours during 2011-2013 were included...
June 21, 2017: Journal of Pediatrics
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