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https://www.readbyqxmd.com/read/28102937/re-implementation-of-an-evidence-based-acute-tonsillitis-protocol-our-experience-in-one-hundred-and-twenty-six-patients
#1
Guled M Jama, Mahmoud Nosseir, Julian Danino, James Barraclough
The 'Portsmouth Tonsillitis Protocol' by Bird et al. (October 2013 issue)([1]) provides the first published treatment algorithm for use in patients with acute tonsillitis presenting to secondary care. Following introduction of the protocol at their centre the authors demonstrate an improved delivery of tonsillitis treatment as well as a reduction in hospital admission rates and inpatient services leading to significant cost savings. The financial implications are particularly relevant to health services facing economic pressures...
January 19, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28102920/evaluation-of-peripheral-intravenous-catheter-induced-local-complications-in-pediatrics
#2
Baraka M R Abusafia, Handan Boztepe
AIM: This study was conducted to evaluate the local complications in children who had a peripheral intravenous catheter. BACKGROUND: Currently, the insertion of peripheral intravenous catheters occurs in most children that are hospitalized. However, the development of some complications associated with the insertion of these catheters are unavoidable. A significant aspect of nursing care is to ensure the safety of the placement and management of peripheral intravenous catheters in children...
January 19, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28101987/delivery-outcomes-of-patients-with-acute-migraine-in-pregnancy-a-retrospective-study
#3
Tracy B Grossman, Shravya Govindappagari, Ashlesha K Dayal, Matthew S Robbins
OBJECTIVE: To describe labor and delivery outcomes in pregnant patients presenting to the hospital setting with an acute severe migraine headache attack earlier in the same gestation. METHODS: We retrospectively reviewed pregnancy and delivery records from a database of consecutive inpatient neurology consultations for acute headache in pregnant women over a 5 year period. RESULTS: We identified 86 pregnant women with acute migraine. The mean age was 29...
January 18, 2017: Headache
https://www.readbyqxmd.com/read/28100942/potential-benefits-of-rib-fracture-fixation-in-patients-with-flail-chest-and-multiple-non-flail-rib-fractures
#4
Meiguang Qiu, Zhanjun Shi, Jun Xiao, Xuming Zhang, Shishui Ling, Hao Ling
The purpose of this study is to evaluate the potential benefits of rib fracture fixation in patients with flail chest and multiple non-flail rib fractures versus conventional treatment modalities. A retrospective reviewed study compared 86 cases which received surgical treatment between June 2009 and May 2013 to 76 cases which received conservative treatment between January 2006 and May 2009. The patients were divided into the flail chest (n = 38) and multiple non-flail rib fracture groups (n = 124)...
December 2016: Indian Journal of Surgery
https://www.readbyqxmd.com/read/28100220/effect-of-patient-s-age-on-the-profitability-of-inpatient-cardiac-catheterization-a-contribution-margin-analysis-of-frequently-performed-procedures-over-a-5-year-period
#5
Gunnar Plehn, Thomas Butz, Petra Maagh, Axel Meissner
BACKGROUND: Due to a continuing age shift in the German society hospital providers are concerned about the additional costs associated with the treatment of elderly patients. It is not clear if cardiac catheterization in aged patients leads to higher resource utilization and if DRG-revenues do compensate for this factor. METHODS: Procedure-related and administrative data of all patients who underwent cardiac catheterization at a tertiary heart center between 2007 and 2011 were collected and analyzed...
January 18, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28099971/warfarin-associated-nonuremic-calciphylaxis
#6
Wesley Yung-Hsu Yu, Tina Bhutani, Rachel Kornik, Laura B Pincus, Theodora Mauro, Michael D Rosenblum, Lindy P Fox
Importance: Classic calciphylaxis associated with renal failure is a life-threatening disease. Warfarin-associated calciphylaxis without renal injury has been described, but whether it is a subset of classic calciphylaxis or a different entity remains unknown. We describe 1 case of warfarin-associated calciphylaxis, present data from 2 others from our institution, and review all cases of warfarin-associated calciphylaxis available in the literature. Our review indicates that warfarin-associated calciphylaxis is clinically and pathophysiologically distinct from classic calciphylaxis...
January 11, 2017: JAMA Dermatology
https://www.readbyqxmd.com/read/28099432/an-analysis-of-the-last-clinical-encounter-before-outpatient-mortality-among-children-with-hiv-infection-and-exposure-in-lilongwe-malawi
#7
Chris A Rees, Robert J Flick, David Sullivan, Menard Bvumbwe, Joseph Mhango, Mina C Hosseinipour, Peter N Kazembe
BACKGROUND: Human immunodeficiency virus (HIV) contributes to nearly 20% of all deaths in children under five years of age in Malawi. Expanded coverage of antiretroviral therapy has allowed children to access treatment on an outpatient basis. Little is known about characteristics of the final outpatient encounter prior to mortality in the outpatient setting. METHODS: This retrospective cohort study assessed clinical factors associated with mortality among HIV-exposed infants and HIV-infected children less than 18 years of age at the Baylor College of Medicine Abbott Fund Children's Center of Excellence in Lilongwe, Malawi...
2017: PloS One
https://www.readbyqxmd.com/read/28099053/palliative-care-involvement-is-associated-with-less-intensive-end-of-life-care-in-adolescent-and-young-adult-oncology-patients
#8
Jennifer M Snaman, Erica C Kaye, Jessie J Lu, April Sykes, Justin N Baker
BACKGROUND: Adolescent and young adult oncology (AYAO) patients often receive intensive medical care and experience significant symptoms at the end of life (EOL). OBJECTIVE: This study aimed to describe the characteristics of AYAO patients aged 15-26 years who died as inpatients in a hospital and to compare the illness and EOL experiences of AYAO patients who did and did not receive palliative care (PC). DESIGN AND SETTING: A standardized data extraction tool was used to collect information about demographics, treatment, terminal characteristics, and symptoms during the last month of life (LMOL) for 69 AYAO patients who died while hospitalized between 2008 and 2014...
January 18, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28097649/hospital-variation-in-utilization-of-life-sustaining-treatments-among-patients-with-do-not-resuscitate-orders
#9
Allan J Walkey, Janice Weinberg, Renda Soylemez Wiener, Colin R Cooke, Peter K Lindenauer
OBJECTIVE: To determine between-hospital variation in interventions provided to patients with do not resuscitate (DNR) orders. DATA SOURCES/SETTING: United States Agency of Healthcare Research and Quality, Healthcare Cost and Utilization Project, California State Inpatient Database. STUDY DESIGN: Retrospective cohort study including hospitalized patients aged 40 and older with potential indications for invasive treatments: in-hospital cardiac arrest (indication for CPR), acute respiratory failure (mechanical ventilation), acute renal failure (hemodialysis), septic shock (central venous catheterization), and palliative care...
January 18, 2017: Health Services Research
https://www.readbyqxmd.com/read/28096898/characteristics-of-adolescents-frequently-restrained-in-acute-psychiatric-units-in-norway-a-nationwide-study
#10
Astrid Furre, Ragnhild Sørum Falk, Leiv Sandvik, Svein Friis, Maria Knutzen, Ketil Hanssen-Bauer
BACKGROUND: The use of restraints in adolescent psychiatric settings requires particular professional, ethical, and legal considerations. The purpose of this study was to investigate whether the number of restraint episodes per patient was related to any of several characteristics of the adolescents. METHODS: In this nationwide study, we included all adolescents restrained during the period 2008-2010 (N = 267) in Norwegian adolescent acute psychiatric inpatient units...
2017: Child and Adolescent Psychiatry and Mental Health
https://www.readbyqxmd.com/read/28096280/consumer-satisfaction-with-tertiary-healthcare-in-china-findings-from-the-2015-china-national-patient-survey
#11
Jing Sun, Guangyu Hu, Jing Ma, Yin Chen, Laiyang Wu, Qiannan Liu, Jia Hu, Christine Livoti, Yu Jiang, Yuanli Liu
OBJECTIVE: This study aims to develop understanding of Chinese patient satisfaction with tertiary hospitals. DESIGN: The study draws on data collected from the 2015 China National Patient Survey. A Likert five-point scale was used to formulate the questionnaires. Descriptive analysis and logistic regression analysis were conducted. SETTING: A structured questionnaire was used by 1432 interviewers to interview 27 475 outpatients and 19 938 inpatients in 136 tertiary hospitals from 31 provinces...
January 16, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28096034/twelve-months-effect-of-self-referral-to-inpatient-treatment-on-patient-activation-recovery-symptoms-and-functioning-a-randomized-controlled-study
#12
I E O Moljord, M L Lara-Cabrera, Ø Salvesen, M B Rise, D Bjørgen, D Ø Antonsen, T M Olsø, G H Evensen, C B Gudde, O M Linaker, A Steinsbekk, L Eriksen
OBJECTIVE: To investigate the effect of having a contract for self-referral to inpatient treatment (SRIT) in patients with severe mental disorders. METHODS: A randomized controlled trial with 53 adult patients; 26 participants received a SRIT contract, which they could use to refer themselves into a Community Mental Health Centre up to five days for each referral without contacting a doctor in advance. Outcomes were assessed after 12 months with the self-report questionnaires Patient Activation Measure (PAM-13), Recovery Assessment Scale (RAS), and the Behavior and Symptom Identification Scale (BASIS-32) and analyzed using linear mixed and regression models...
January 11, 2017: Patient Education and Counseling
https://www.readbyqxmd.com/read/28096011/a-systematic-nurse-led-approach-to-withdrawal-risk-screening-prevention-and-treatment-among-inpatients-with-an-alcohol-use-disorder-in-an-ear-nose-throat-and-jaw-surgery-department-a-formative-evaluation
#13
Deborah Linda Leuenberger, Katharina Fierz, Andreas Hinck, Daniel Bodmer, Wolfgang Hasemann
INTRODUCTION: Among patients with head and neck cancer comorbid alcohol use disorder is frequent which contributes to higher risk of developing perioperative alcohol withdrawal syndrome/delirium or delirium due to medical conditions. Although guidelines emphasize prevention and treatment of alcohol withdrawal in hospitalized patients, a validated systematic approach for management of these patients is still lacking. Our aim was to formatively evaluate our newly developed systematic approach in view of nurses' adherence to screening patients for regular alcohol consumption and managing their withdrawal symptoms using the Clinical Institute Withdrawal Assessment of Alcohol Scale, Revised...
February 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28095826/non-invasive-respiratory-support-for-infants-with-bronchiolitis-a-national-survey-of-practice
#14
H Turnham, R S Agbeko, J Furness, J Pappachan, A G Sutcliffe, P Ramnarayan
BACKGROUND: Bronchiolitis is a common respiratory illness of early childhood. For most children it is a mild self-limiting disease but a small number of children develop respiratory failure. Nasal continuous positive airway pressure (nCPAP) has traditionally been used to provide non-invasive respiratory support in these children, but there is little clinical trial evidence to support its use. More recently, high-flow nasal cannula therapy (HFNC) has emerged as a novel respiratory support modality...
January 17, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28095806/predictors-of-mental-health-review-tribunal-mhrt-outcome-in-a-forensic-inpatient-population-a-prospective-cohort-study
#15
Amelia Jewell, Kimberlie Dean, Tom Fahy, Alexis E Cullen
BACKGROUND: Previous studies have investigated factors associated with outcome at Mental Health Review Tribunals (MHRTs) in forensic psychiatric patients; however, dynamic variables such as treatment compliance and substance misuse have scarcely been examined, particularly in UK samples. We aimed to determine whether dynamic factors related to behaviour, cooperation with treatment, and activities on the ward were prospectively associated with outcome at MHRT. METHODS: At baseline, demographic, clinical, behavioural, and treatment-related factors were ascertained via electronic medical records and census forms completed by the patient's clinical team...
January 17, 2017: BMC Psychiatry
https://www.readbyqxmd.com/read/28095267/survival-after-early-stage-breast-cancer-of-women-previously-treated-for-depression-a-nationwide-danish-cohort-study
#16
Nis P Suppli, Christoffer Johansen, Lars V Kessing, Anita Toender, Niels Kroman, Marianne Ewertz, Susanne O Dalton
Purpose The aim of this nationwide, register-based cohort study was to determine whether women treated for depression before primary early-stage breast cancer are at increased risk for receiving treatment that is not in accordance with national guidelines and for poorer survival. Material and Methods We identified 45,325 women with early breast cancer diagnosed in Denmark from 1998 to 2011. Of these, 744 women (2%) had had a previous hospital contact (as an inpatient or outpatient) for depression and another 6,068 (13%) had been treated with antidepressants...
January 20, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28095134/physical-and-occupational-therapy-for-a-teenager-with-acute-flaccid-myelitis-a-case-report
#17
Tracy Kornafel, Elaine Y Tsao, Emily Sabelhaus, Lori Surges, Susan D Apkon
AIMS: The purpose of this case report is to describe the inpatient rehabilitation program of a 13-year-old boy with acute flaccid myelitis (AFM), specific to physical and occupational therapy examination, treatment, and outcomes. CASE DESCRIPTION: AFM is a rare, acute neurologic illness in children and young adults who present with weakness and/or paralysis of unknown etiology. The teenager was admitted to the program, dependent for all mobility and self-care. Interventions focused on range of motion, transfer training, self-care, power wheelchair mobility, and environmental adaptations...
January 17, 2017: Physical & Occupational Therapy in Pediatrics
https://www.readbyqxmd.com/read/28094189/medicaid-payer-status-is-linked-to-increased-rates-of-complications-after-treatment-of-proximal-humerus-fractures
#18
Vani J Sabesan, Graysen Petersen-Fitts, Daniel Lombardo, Daniel Briggs, James Whaley
BACKGROUND: Low socioeconomic status and Medicaid insurance as a primary payer have been associated with major disparities in resource utilization and risk-adjusted outcomes for patients undergoing total joint arthroplasty. With the expansion of Medicaid through the Affordable Care Act in 2014, examination of these disparities has become increasingly relevant for the treatment of proximal humerus fracture (PHF). METHODS: The Healthcare Cost and Utilization Project Nationwide Inpatient Sample database was used to identify patients who were treated for PHF from 2002 to 2012...
January 13, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28093003/outcome-for-patients-with-relapsed-refractory-aggressive-lymphoma-treated-with-gemcitabine-and-oxaliplatin-with-or-without-rituximab-a-retrospective-multicentre-study
#19
Vijay Dhanapal, Menaka Gunasekara, Chia Lianwea, Robert Marcus, Corinne De Lord, Stella Bowcock, Stephen Devereux, Piers Patten, Deborah Yallop, David Wrench, Paul Fields, Shireen Kassam
The treatment of relapsed aggressive lymphoma remains a challenge. Platinum-containing chemotherapy is standard of care. Gemcitabine/oxaliplatin (Gem-Ox) with or without rituximab (R) is an outpatient regimen with a favorable toxicity profile. This retrospective 'real world' study reports outcomes for 44 unselected patients with relapsed/refractory aggressive lymphoma treated with Gem-Ox ± R. 41% had primary refractory disease. The overall response rate (ORR) was 43% with a complete response (CR) of 30%...
January 16, 2017: Leukemia & Lymphoma
https://www.readbyqxmd.com/read/28092798/acute-kidney-injury-and-risk-of-deep-vein-thrombosis-and-pulmonary-embolism-in-taiwan-a-nationwide-retrospective-cohort-study
#20
Tsung-Hang Kuo, Hsin-Yang Li, Sheng-Hsiang Lin
INTRODUCTION: Chronic kidney disease (CKD) increases risk for deep vein thrombosis (DVT) and pulmonary embolism (PE). However, few studies have investigated the relationship between acute kidney injury (AKI) and risk of DVT and PE. Therefore, we conducted a nationwide longitudinal cohort study to determine whether patients with AKI are associated with increased risk of developing DVT and PE. METHODS: We included >30years-old inpatients (n=4734) receiving the diagnosis of AKI from 2000 to 2006 and their age-and sex-matched non-AKI inpatients using medical service in the same year (n=47...
January 6, 2017: Thrombosis Research
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