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https://www.readbyqxmd.com/read/28214078/the-optimize-heart-failure-care-program-initial-lessons-from-global-implementation
#1
Martin R Cowie, Yuri M Lopatin, Clara Saldarriaga, Cândida Fonseca, David Sim, Jose Antonio Magaña, Denilson Albuquerque, Marcelo Trivi, Gustavo Moncada, Baldomero A González Castillo, Mario Osvaldo Speranza Sánchez, Edward Chung
Hospitalization for heart failure (HF) places a major burden on healthcare services worldwide, and is a strong predictor of increased mortality especially in the first three months after discharge. Though undesirable, hospitalization is an opportunity to optimize HF therapy and advise clinicians and patients about the importance of continued adherence to HF medication and regular monitoring. The Optimize Heart Failure Care Program (www.optimize-hf.com), which has been implemented in 45 countries, is designed to improve outcomes following HF hospitalization through inexpensive initiatives to improve prescription of appropriate drug therapies, patient education and engagement, and post-discharge planning...
February 12, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28201995/zoonotic-necrotizing-myositis-caused-by-streptococcus-equi-subsp-zooepidemicus-in-a-farmer
#2
Bård Reiakvam Kittang, Veronika Kuchařová Pettersen, Oddvar Oppegaard, Dag Harald Skutlaberg, Håvard Dale, Harald G Wiker, Steinar Skrede
BACKGROUND: Streptococcus equi subsp. zooepidemicus is a beta-hemolytic group C streptococcus mainly causing infections in domesticated animals. Here we describe the first case of zoonotic necrotizing myositis caused by this bacterium. CASE PRESENTATION: The patient was a 73-year-old, previously healthy farmer with two asymptomatic Shetland ponies in his stable. After close contact with the ponies while feeding them, he rapidly developed erythema of his left thigh and sepsis with multiple organ failure...
February 15, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28176308/fluid-restriction-for-treatment-of-preterm-infants-with-chronic-lung-disease
#3
REVIEW
Keith J Barrington, Etienne Fortin-Pellerin, Thomas Pennaforte
BACKGROUND: Fluid restriction is often recommended as part of the management of infants with early or established bronchopulmonary dysplasia (BPD). OBJECTIVES: To determine whether fluid restriction as part of the therapeutic intervention for early or established BPD improves clinical outcomes. SEARCH METHODS: We used the standard search strategy of Cochrane Neonatal to search the Cochrane Central Register of Controlled Trials (CENTRAL; 2016, Issue 1) in the Cochrane Library (searched 16 February 2016), MEDLINE via PubMed (1966 to 16 February 2016), Embase (1980 to 16 February 2016), and CINAHL (1982 to 16 February 2016)...
February 8, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28174148/local-anesthesia-versus-local-anesthesia-and-conscious-sedation-for-inguinal-hernioplasty-protocol-of-a-randomized-controlled-trial
#4
Pierre-Anthony Leake, Patrick J Toppin, Marvin Reid, Joseph M Plummer, Patrick O Roberts, Hyacinth Harding-Goldson, Michael E McFarlane
BACKGROUND: Conscious sedation is regularly used in ambulatory surgery to improve patient outcomes, in particular patient satisfaction. Reports suggest that the addition of conscious sedation to local anesthesia for inguinal hernioplasty is safe and effective in improving patient satisfaction. No previous randomized controlled trial has assessed the benefit of conscious sedation in this regard. OBJECTIVE: To determine whether the addition of conscious sedation to local anesthesia improves patient satisfaction with inguinal hernioplasty...
February 7, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28174032/emergency-medicine-myths-epinephrine-in-cardiac-arrest
#5
Brit Long, Alex Koyfman
BACKGROUND: Sudden cardiac arrest accounts for approximately 15% of deaths in developed nations, with poor survival rate. The American Heart Association states that epinephrine is reasonable for patients with cardiac arrest, though the literature behind its use is not strong. OBJECTIVE: To review the evidence behind epinephrine for cardiac arrest. DISCUSSION: Sudden cardiac arrest causes over 450,000 deaths annually in the United States. The American Heart Association recommends epinephrine may be reasonable in patients with cardiac arrest, as part of Advanced Cardiac Life Support...
February 4, 2017: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28169819/-study-of-two-indicators-of-difficulty-in-initiating-maternal-breastfeeding-160-maternal-fatigue-and-suboptimal-infant-breastfeeding-behaviour
#6
Latifa Saidi, Pierre Godbout
<ce:para>The problems with setting up breastfeading are common and are associated with a heightened risk of weening. The main motives brought up by the mothers for early weening were fatigue and the suboptimal infant breastfeeding behaviour (SIBB). The goal of this study is to describe the fatigue levels of breastfeading women who gave birth to healthy full term babies in a hospital setting and the SIBB. This study also examines the relation between these two variables.</ce:para><ce:para>This descriptive correlational and cross-sectional study was conducted with breasfeeding women who gave birth to healthy, full term, single babies at the CHU in Moncton between June and September 2013...
July 5, 2016: Recherche en Soins Infirmiers
https://www.readbyqxmd.com/read/28166447/nutrition-support-for-persistent-inflammation-immunosuppression-and-catabolism-syndrome
#7
Frederick A Moore, Stuart Phillips, Craig McClain, Jayshil J Patel, Robert Martindale
Despite tremendous advances in critical care, multiple-organ failure continues to be a significant problem. However, in recent years, far fewer patients with multiple-organ failure die early, but many experience ongoing immune dysregulation and are developing persistent inflammation, immunosuppression, and catabolism syndrome (PICS). Most PICS patients are discharged to nonhome destinations, fail to rehabilitate, and succumb to indolent death. From a nutrition perspective, patients with PICS experience persistent inflammation-induced cachexia despite evidenced-based recommended intensive care unit nutrition support...
February 1, 2017: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/28163938/evaluating-complications-of-chronic-sinusitis
#8
Phillip Hong, Charles A Pereyra, Uta Guo, Adam Breslin, Laura Melville
Chronic sinusitis is a relatively common diagnosis throughout the US. In patients with an otherwise unremarkable medical history the treatment is typically supportive, requiring only clinical evaluation. We present the case of a 25-year-old male with a history of chronic sinusitis that was brought to our emergency department with new-onset seizure. Three days before he had presented to his usual care facility with two days of headache and fever and was discharged stating headache, subjective fever, and neck stiffness...
2017: Case Reports in Emergency Medicine
https://www.readbyqxmd.com/read/28163432/early-primary-graft-failure-after-a-pediatric-heart-transplant-and-successful-rescue-with-plasmapheresis-immunoglobulins-and-alemtuzumab
#9
Shashi Raj, Phillip Ruiz, Paolo Rusconi
Early primary graft failure after pediatric orthotopic heart transplantation (OHT) has a high mortality rate and can occur due to several causes including but not limited to prolonged graft ischemia time, suboptimal preimplant myocardial preservation, hyperacute rejection, and maladaptation of the graft to the host's hemodynamic status. Mechanical circulatory support with either extracorporeal membrane oxygenation (ECMO) or ventricular assist device has been used for the rescue of primary graft failure in pediatric patients after heart transplant...
January 2017: Annals of Pediatric Cardiology
https://www.readbyqxmd.com/read/28159130/early-discharge-following-birth-what-characterises-mothers-and-newborns
#10
Ingrid M S Nilsson, Hanne Kronborg, Christopher H Knight, Katrine Strandberg-Larsen
BACKGROUND: Early postnatal discharge has increased over the past 50 years and today we lack the knowledge on who is discharged early that would allow us to improve quality of postnatal care. The aim of this study was to describe maternal and infant predictors for early postnatal discharge in a country with equal access to health care. METHODS: An observational study of 2786 mothers, recruited in pregnancy was conducted from April 2013 to August 2014 in four of the five regions in Denmark...
March 2017: Sexual & Reproductive Healthcare: Official Journal of the Swedish Association of Midwives
https://www.readbyqxmd.com/read/28157644/the-future-for-follow-up-of-gynaecological-cancer-in-europe-summary-of-available-data-and-overview-of-ongoing-trials
#11
REVIEW
S C Leeson, K Beaver, N P M Ezendam, R Mačuks, P L Martin-Hirsch, T Miles, M M Jeppesen, P T Jensen, P Zola
After completing treatment, most patients follow a pre-determined schedule of regular hospital outpatient appointments, which includes clinical examinations, consultations and routine tests. After several years of surveillance, patients are transferred back to primary care. However, there is limited evidence to support the effectiveness and efficiency of this approach. This paper examines the current rationale and evidence base for hospital-based follow-up after treatment for gynaecological cancer. We investigate what alternative models of care have been formally evaluated and what research is currently in progress in Europe, in order to make tentative recommendations for a model of follow-up...
January 19, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28156486/referral-patterns-among-patients-with-metastatic-breast-cancer-in-an-integrated-palliative-care-program
#12
Jeffrey Belkora, Melanie Catherine Majure, Amy Jo Chien, Michelle E Melisko, Hope S Rugo, Michael W Rabow
: 163 Background: ASCO recommends palliative care (PC) concurrently with oncologic treatment for patients with metastatic disease and there is emerging data about the benefits of early PC. However, little is known about referral patterns to specialty PC among patients who die of metastatic breast cancer. METHODS: After years of offering a stand-alone outpatient PC consult service in our comprehensive cancer center, we established an integrated PC program in breast oncology (the "Advanced Breast Cancer (ABC) Program") with a care coordinator, PC physician, and co-location with oncology...
October 9, 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28152330/randomized-controlled-trial-on-effect-of-intermittent-early-versus-late-kangaroo-mother-care-on-human-milk-feeding-in-low-birth-weight-neonates
#13
Dhaarani Jayaraman, Kanya Mukhopadhyay, Anil Kumar Bhalla, Lakhbir Kaur Dhaliwal
BACKGROUND: Breastfeeding at discharge among sick low-birth-weight (LBW) infants is low despite counseling and intervention like kangaroo mother care (KMC). Research aim: The aim was to study the effects of early initiation of KMC on exclusive human milk feeding, growth, mortality, and morbidities in LBW neonates compared with late initiation of KMC during the hospital stay and postdischarge. METHODS: A randomized controlled trial was conducted in level 2 and 3 areas of a tertiary care neonatal unit over 15 months...
February 1, 2017: Journal of Human Lactation: Official Journal of International Lactation Consultant Association
https://www.readbyqxmd.com/read/28145162/early-use-of-corticosteroids-in-infants-with-a-clinical-diagnosis-of-pneumocystis-jiroveci-pneumonia-in-malawi-a-double-blind-randomised-clinical-trial
#14
Laura Newberry, Bernadette O'Hare, Neil Kennedy, Andrew Selman, Sofia Omar, Pamela Dawson, Kim Stevenson, Yo Nishihara, Samantha Lissauer, Elizabeth Molyneux
BACKGROUND: Pneumocystis jiroveci pneumonia (PJP) is the most common opportunistic infection in infants with vertically acquired HIV infection and the most common cause of death in HIV-infected infants. OBJECTIVES: To determine whether early administration of adjuvant corticosteroids in addition to standard treatment reduces mortality in infants with vertically acquired HIV and clinically diagnosed PJP when co-infection with cytomegalovirus and other pathogens cannot be excluded...
February 1, 2017: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/28143633/electronic-alerts-for-acute-kidney-injury
#15
Michael Haase, Andreas Kribben, Walter Zidek, Jürgen Floege, Christian Albert, Berend Isermann, Bernt-Peter Robra, Anja Haase-Fielitz
BACKGROUND: Acute kidney injury (AKI) often takes a complicated course if diagnosed late and undertreated. Electronic alerts that provide an early warning of AKI are intended to support treating physicians in making the diagnosis of AKI and treating it appropriately. The available evidence on the effects of such alert systems is inconsistent. METHODS: We employed the PRISMA recommendations for systematic literature reviews to identify relevant articles in the PubMed, Scopus, and Web of Science databases...
January 9, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/28134678/what-is-new-in-the-management-of-skin-and-soft-tissue-infections-in-2016
#16
Garyphallia Poulakou, Efthymia Giannitsioti, Sotirios Tsiodras
PURPOSE OF REVIEW: Skin and soft tissue infections (SSTIs) are the most frequent infectious cause of referrals to emergency departments and hospital admissions in developed world, contributing to significant morbidity and healthcare expenditures. We sought to review recent literature covering epidemiology and management of SSTIs. RECENT FINDINGS: Incidence trends of SSTIs were increasing worldwide with Staphylococcus aureus and streptococci predominating and methicillin-resistant S...
January 27, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28134677/are-there-any-reasons-to-change-our-behavior-in-necrotizing-fasciitis-with-the-advent-of-new-antibiotics
#17
Francesco Menichetti, Simone Giuliano, Simona Fortunato
PURPOSE OF REVIEW: The treatment of necrotizing fasciitis requires a multifaceted approach, consisting of surgical source control with immediate surgical debridement along with life support, clinical monitoring, and antimicrobial therapy. Many drugs are now available for the treatment of this life-threatening infectious disease, and the purpose of this review is to provide the reader with an updated overview of the newest therapeutic options. RECENT FINDINGS: Because most necrotizing soft tissue infections are polymicrobial, broad-spectrum coverage is advisable...
January 27, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28133091/-two-cases-pancreatic-carcinoma-detected-incidentally-during-treatment-of-acute-abdomen-from-other-causes
#18
Shigeru Fujisaki, Motoi Takashina, Ryouichi Tomita, Kenichi Sakurai, Tadatoshi Takayama
We report 2 cases of pancreatic cancer discovered incidentally in the wake of acute abdomen from other causes. Case 1 is a 67-year-old man who was referred to our hospital in October 2010 for the treatment of an incarcerated right inguinal hernia. The hernia was manually reduced, and mesh plug hernioplasty was scheduled for the next day. A 2.9 cm diameter tumor was detected in the tail of the pancreas on plain CT at the first visit and confirmed on enhanced CT soon after the hernia repair. A follow-up abdominal CT scan approximately 1 month later showed modest enlargement of the tumor to 3...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/28123918/severe-legionella-pneumophila-infection-in-an-immunocompetent-patient-a-success-story-300-kilometers-away
#19
Miguel Jacob, Helena C Ramos, Bruno Morgado
The most significant outbreak of Legionella pneumophila, or Legionnaires' Disease, ever registered in Portugal occurred in 2014, and was considered one of the largest in European history. This relatively rare infection has a dire prognosis if not timely identified and correctly treated, presenting with a high lethality rate. We describe a case of infection by Legionella pneumophila in a previously healthy individual during an outbreak that originated 300 kilometers away from our hospital. The patient presented to the Emergency Department and after an initial assessment, was admitted to the Intensive Care Unit (ICU)...
December 21, 2016: Curēus
https://www.readbyqxmd.com/read/28118782/initial-experience-with-xenograft-bioconduit-for-the-treatment-of-complex-prosthetic-valve-endocarditis
#20
Apostolos Roubelakis, Dimos Karangelis, Syed Sadeque, Bobby Yanagawa, Amit Modi, Clifford W Barlow, Steven A Livesey, Sunil K Ohri
INTRODUCTION: The treatment of complex prosthetic valve endocarditis (PVE) with aortic root abscess remains a surgical challenge. Several studies support the use of biological tissues to minimize the risk of recurrent infection. We present our initial surgical experience with the use of an aortic xenograft conduit for aortic valve and root replacement. METHODS: Between October 2013 and August 2015, 15 xenograft bioconduits were implanted for complex PVE with abscess (13...
January 1, 2017: Perfusion
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