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https://www.readbyqxmd.com/read/28550759/venous-thromboembolism-in-the-elderly-a-narrative-review
#1
REVIEW
T Tritschler, D Aujesky
Persons aged ≥65years not only account for over 60% of venous thromboembolism (VTE) events, they have also a higher mortality and VTE-related morbidity than younger patients, including anticoagulation-related bleeding and the postthrombotic syndrome. However, only few studies have focused specifically on VTE in older persons and practice guidelines commonly extrapolate study results from younger healthier patients to the multimorbid elderly. Evidence suggests that the clinical presentation is more subtle in the elderly with VTE and that commonly used diagnostic modalities, including clinical prediction rules, D-dimer tests, and planar ventilation-perfusion scans are less specific and efficient in older persons...
May 17, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28549914/timing-of-permanent-ventricular-shunt-placement-following-external-ventricular-drain-placement-in-primary-intracerebral-hemorrhage
#2
Steven Ray Peters, David Tirschwell
BACKGROUND: Intraventricular hemorrhage requiring ventriculostomy placement is a frequent complication of spontaneous intracerebral hemorrhage. Although a subset of patients will require permanent ventricular shunt placement, little is known about contemporary practices regarding the timing of ventriculostomy and ventricular shunt placement after intracerebral hemorrhage. METHODS: Using the 2010-2012 National Inpatient Sample, we identified patients with International Classification of Diseases, Ninth Revision codes for intracerebral hemorrhage, excluded secondary causes, and examined procedure dates...
May 23, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28549574/screening-for-psychologic-distress-in-taiwanese-cancer-inpatients-using-the-national-comprehensive-cancer-network-distress-thermometer-the-effects-of-patients-sex-and-chemotherapy-experience
#3
Yu-Jie Chiou, Chun-Yi Lee, Shau-Hsuan Li, Mian-Yoon Chong, Yu Lee, Liang-Jen Wang
BACKGROUND: Patients with cancer often experience distress, and early detection and management of psychologic distress are vital for improving patients' outcomes. OBJECTIVE: This study investigates the validity and determines the optimal cutoff score-for clinically significant distress-for the Taiwanese Distress Thermometer (DT). METHODS: This study consisted of 768 inpatients diagnosed with cancer in a general hospital in southern Taiwan...
April 6, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28549048/disposable-versus-reusable-absorbent-underpads-for-prevention-of-hospital-acquired-incontinence-associated-dermatitis-and-pressure-injuries
#4
Kathleen Francis, Sau Man Pang, Brenda Cohen, Helene Salter, Peter Homel
PURPOSE: The primary purpose of our study was to determine if there is a difference in the occurrence of hospital-acquired pressure injuries (HAPIs) and incontinence-associated dermatitis (IAD) in incontinent adults using a disposable versus reusable absorptive underpads. We also compared hospital length of stay in the 2 groups. DESIGN: Randomized controlled trial using cluster randomization based on inpatient care unit. SUBJECTS AND SETTING: Four hundred sixty-two patients admitted to 4 medical-surgical study units participated in the study; 252 used reusable underpads (control group) and 210 subjects used disposable underpads (intervention group)...
May 25, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28549013/effect-of-preoperative-diabetes-management-on-glycemic-control-and-clinical-outcomes-after-elective-surgery
#5
Rajesh Garg, Brooke Schuman, Angela Bader, Shelley Hurwitz, Alexander Turchin, Patricia Underwood, Cheyenne Metzger, Raquel Rein, Meghan Lortie
OBJECTIVE: The aim of this study was to evaluate whether preoperative diabetes management can improve glycemic control and clinical outcomes after elective surgery. BACKGROUND: There is lack of data on the importance of diabetes treatment before elective surgery. Diabetes is often ignored before surgery and aggressively treated afterwards. METHODS: Patients with diabetes were identified and treated proactively before their scheduled surgeries...
May 25, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28548574/overdose-education-and-naloxone-distribution-for-veterans-with-opioid-use-disorder-results-from-a-pilot-initiative
#6
Grace Chang, Michelle Davids, Alan Kershaw
Background Patients with opioid use disorder (OUD) are at high risk of overdose. To minimize that risk, a program offering intranasal naloxone rescue kits was piloted at a Veterans Administration Hospital. The purpose of this study was to characterize the veterans who accepted these potentially lifesaving kits. Methods Retrospective medical chart review of 158 veterans with OUD receiving treatment on either the inpatient psychiatry detoxification units or outpatient methadone maintenance setting who were offered overdose education and naloxone rescue (OEND) kits...
May 26, 2017: Journal of Addictive Diseases
https://www.readbyqxmd.com/read/28547859/giant-cell-tumor-of-the-mobile-spine-occurring-in-pregnancy-a-case-report-and-literature-review
#7
Kai Zheng, Ming Xu, Bing Wang, Xiu-Chun Yu, Yong-Cheng Hu
Giant cell tumor (GCT) is a benign, locally aggressive tumor that rarely occurs in the spine. They usually occur in patients between 20 and 40 years of age; some patients with GCT present in hospital with pregnancy. The management of these patients can be challenging. The current study reports a case of GCT located in the sixth thoracic vertebra of a 31-year-old female at 34 weeks of gestation. An osteolytic lesion, 3.5 cm × 3.5 cm in diameter, was identified on CT. An MRI test of the lesion revealed a soft tissue mass involving the T 6-7 vertebrae, extending to the right pedicle of the T 6 vertebra and causing significant spinal cord compression...
May 26, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28547682/adherence-to-clinical-guidelines-and-the-potential-economic-benefits-of-admission-avoidance-for-acute-uncomplicated-diverticulitis
#8
I S Reynolds, E O'Connell, R M Heaney, W Khan, I Z Khan, R Waldron, K Barry
BACKGROUND: The treatment paradigm for acute diverticulitis is changing. There is an increasing trend towards managing patients with uncomplicated diverticulitis in the community. AIMS: The aim of this study was to analyse how acute diverticulitis is managed in our institution and also to analyse national data pertaining to treatment of acute diverticulitis. METHODS: A prospective database of all patients admitted to our institution over a 2-year period (2014-2016) with acute diverticulitis was maintained...
May 25, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28547273/case-distribution-and-complications-of-mid-urethral-sling-surgery-in-a-canadian-city-before-and-after-the-health-canada-advisory-on-pelvic-floor-mesh
#9
Kevin Carlson, Richard Baverstock, Andrea Civitarese, R Trafford Crump
INTRODUCTION AND HYPOTHESIS: Increased incidences of complications related to the use of mid-urethral slings (MUS) for the treatment of stress urinary incontinence resulted in both the Food and Drug Administration (FDA) and Health Canada issuing advisories in 2008 and 2010 respectively. The purpose of this study was to assess the effect these advisories had on the number of surgeons performing MUS surgery and post-surgical complications in Calgary, Canada. METHODS: In this study, we conducted a retrospective analysis of administrative data between 2006 and 2011...
May 25, 2017: International Urogynecology Journal
https://www.readbyqxmd.com/read/28545828/effectiveness-of-environmental-control-measures-to%C3%A2-decrease-the-risk-of-invasive-aspergillosis-in-acute-leukaemia-patients-during-hospital-building-work
#10
J F Combariza, L F Toro, J J Orozco
BACKGROUND: Invasive aspergillosis (IA) is a significant problem in acute leukaemia patients. Construction work near hospital wards caring for immunocompromised patients is one of the main risk factors for developing invasive pulmonary aspergillosis (IPA). AIM: To assess the impact of environmental control measures used during hospital construction for the prevention of IA in acute leukaemia patients. METHODS: A retrospective cohort study was developed to evaluate the IA incidence in acute leukaemia patients with different environmental control measures employed during hospital construction...
May 5, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28545201/treatment-experiences-of-women-with-reproductive-cancers-in-odisha-india-a-qualitative-exploration-of-enablers-and-barriers
#11
Sanghamitra Pati, Abhimanyu Singh Chauhan, Sandeep Mahapatra, Sabita Nayak, Sukdev Nayak, David Weller
Introduction: Cancer continues to be a major menace to our Indian society notwithstanding significant progress in diagnosis and treatment. In India cancer mortality rates in women are high compared to other countries, despite efforts to improve survival through the development of effective detection techniques and increased numbers of viable treatment options. Indian women’s advanced stage of disease at diagnosis is largely attributable to delay in seeking treatment. The present qualitative inquiry was conducted with the aim of capturing the treatment experiences of patients with gynecology cancer at a tertiary care hospital and understanding the barriers, enablers, stress and apprehension they experience during the treatment phases...
April 1, 2017: Asian Pacific Journal of Cancer Prevention: APJCP
https://www.readbyqxmd.com/read/28545129/direct-and-indirect-costs-of-diabetes-mellitus-in-mali-a-case-control-study
#12
Clara Bermudez-Tamayo, Stéphane Besançon, Mira Johri, Sidibe Assa, Jonathan Betz Brown, Kaushik Ramaiya
BACKGROUND: Diabetes mellitus (DM) is one of the most burdensome chronic diseases and is associated with shorter lifetime, diminished quality of life and economic burdens on the patient and society as a result of healthcare, medication, and reduced labor market participation. We aimed to estimate the direct (medical and non-medical) and indirect costs of DM and compare them with those of people without DM (ND), as well as the cost predictors. METHODS AND FINDINGS: Observational retrospective case-control study performed in Mali...
2017: PloS One
https://www.readbyqxmd.com/read/28544132/-can-not-talk-about-it-urinary-incontinence-from-the-point-of-view-of-stroke-survivors-a-qualitative-study
#13
Myrta Kohler, Hanna Mayer, Jürg Kesselring, Susi Saxer
PURPOSE: The current study intends to gain an in-depth understanding of stroke survivors' lived experience of urinary incontinence and its treatment in an inpatient rehabilitation clinic. METHODS: A qualitative approach was chosen. Semi-structured individual interviews with ten stroke survivors suffering from urinary incontinence were conducted in an inpatient rehabilitation clinic and analysed using qualitative content analysis with an inductive approach. RESULTS: '(Can) not talk about it' was identified as the first main category...
May 24, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/28544081/direct-medical-costs-of-severe-hypoglycaemic-events-in-patients-with-type-2-diabetes-in-england-a-retrospective-database-study
#14
Tim Holbrook, Yuexin Tang, Romita Das, R Ravi Shankar, Kaan Tunceli, Jean Williams, Larry Radican, Sarah E Holden, Chris Ll Morgan, James Piercy, Craig J Currie
AIMS: Hypoglycaemia in patients with diabetes can be induced by insulins and sulfonylureas. We assessed the real-world impact of specific monotherapy and combination regimens on hypoglycaemic events requiring hospitalisation and related secondary costs to the English healthcare system. METHODS: This retrospective observational study used the Clinical Practice Research Datalink with linked hospital admission data during 2008-2012. Patients with type 2 diabetes mellitus (T2DM) using antihyperglycaemic agents (AHAs) were assigned to mutually exclusive subgroups (insulin- and non-insulin-containing regimens; treatment groups of interest; age group) based on treatment at index date (date of first AHA prescription)...
May 23, 2017: International Journal of Clinical Practice
https://www.readbyqxmd.com/read/28544041/marked-variability-observed-in-inpatient-management-of-bronchiolitis-in-three-finnish-hospitals
#15
Varpu Elenius, Eija Bergroth, Petri Koponen, Sami Remes, Pedro A Piedra, Janice A Espinola, Matti Korppi, Carlos A Camargo, Tuomas Jartti
AIM: Infants hospitalised for bronchiolitis undergo examinations and treatments not supported by current research evidence and we investigated practice variations with regard to Finnish children under the age of two. METHODS: This prospective, multi-centre cohort study was conducted in paediatric units in three university hospitals in Finland from 2008-2010. Hospital medical records were reviewed to collect data on clinical course, testing and treatment. Data were analysed separately for children meeting our strict definition of bronchiolitis, aged under 12 months without a history of wheezing, and a loose definition, aged 12-23 months or with a history of wheezing...
May 24, 2017: Acta Paediatrica
https://www.readbyqxmd.com/read/28543716/an-atopic-dermatitis-management-algorithm-for-primary-care-providers-and-assessment-of-its-usefulness-as-a-clinical-tool
#16
Maria E Miyar, Megan Brown, Karina L Vivar, Kimberly Jablon, Christy Boscardin, Moise L Levy, Joyce M Teng, Erin F Mathes
BACKGROUND/OBJECTIVES: There is a lack of primary care provider (PCP) understanding of atopic dermatitis (AD) treatments and topical steroid use. We designed an AD management algorithm for pediatric PCPs. We hypothesized that the algorithm would improve pediatric PCPs' knowledge of AD diagnosis and management. METHODS: Pediatric primary care resident and attending physicians at three residency programs were invited to participate in an electronic AD algorithm survey that contained demographic and 19 knowledge-based questions...
May 25, 2017: Pediatric Dermatology
https://www.readbyqxmd.com/read/28543320/processes-in-acceptance-and-commitment-therapy-and-the-rehabilitation-of-chronic-fatigue
#17
Henrik Børsting Jacobsen, Håvard Kallestad, Nils Inge Landrø, Petter C Borchgrevink, Tore C Stiles
Acceptance and commitment therapy (ACT) has never been tested for patients with chronic fatigue. We aimed to test if a 3.5-week ACT rehabilitation program for patients with chronic fatigue improved quality of life (QoL), fatigue, and psychological flexibility. Further, to test if improvements in QoL and fatigue were associated with improvement in psychological flexibility, and if psychological flexibility explained variance above and beyond maladaptive cognitions typically targeted in CBT for fatigue. Patients (n = 140) who had been on sick leave > 8 weeks due to chronic fatigue received a 3...
June 2017: Scandinavian Journal of Psychology
https://www.readbyqxmd.com/read/28542894/risk-factors-of-falls-among-inpatients-with-cancer
#18
M D Jun, K M Lee, S A Park
AIM: To investigate the risk factors and predictors of falls according to the general characteristics, conscious state, physical condition and treatment of hospitalized patients with cancer. BACKGROUND: Inpatients with cancer experience falls more frequently than those without cancer, and the degree of injuries is more severe among inpatients with cancer. A specific fall prevention strategy is needed for each patient. Prevention of falls in patients with cancer is very important for improving the quality of nursing care...
May 25, 2017: International Nursing Review
https://www.readbyqxmd.com/read/28541411/better-outcomes-and-reduced-hospitalization-cost-are-associated-with-ultra-early-treatment-of-ruptured-intracranial-aneurysms-a-us-nationwide-data-sample-study
#19
Ashish Sonig, Hussain Shallwani, Sabareesh K Natarajan, Hakeem J Shakir, L Nelson Hopkins, Kenneth V Snyder, Adnan H Siddiqui, Elad I Levy
BACKGROUND: The benefit of surgical treatment of ruptured aneurysms is well established. OBJECTIVE: To determine whether ultra-early ruptured aneurysm treatment leads to not only improved outcomes but also reduced hospitalization cost. METHODS: Using 2008-2011 Nationwide Inpatient Sample data, we analyzed demographic, clinical, and hospital factors for nontraumatic subarachnoid hemorrhage (SAH) patients who were "directly" admitted to the treating hospital where they underwent intervention (clipping/coiling)...
May 25, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28541060/metacognition-and-cognition-in-inpatient-mct-and-cbt-for-comorbid-anxiety-disorders-a-study-of-within-person-effects
#20
Sverre Urnes Johnson, Asle Hoffart, Hans M Nordahl, Pål G Ulvenes, KariAnne Vrabel, Bruce E Wampold
Psychotherapists have long questioned what mediating processes are linked to outcome of psychotherapy. Few studies examining this question have assessed within-person changes in the process outcome relationship over time. The present study examined changes in cognition and metacognition over the course of therapy using a dataset from a randomized controlled trial comparing Metacognitive therapy (MCT) and Cognitive-behavioral therapy (CBT). The sample included 74 patients measured on process and symptom instruments weekly throughout therapy...
May 25, 2017: Journal of Counseling Psychology
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