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https://www.readbyqxmd.com/read/28646357/management-of-hyperglycemia-and-diabetes-in-the-emergency-department
#1
REVIEW
Justin B Echouffo-Tcheugui, Rajesh Garg
PURPOSE OF REVIEW: Hyperglycemia in the emergency department (ED) is being recognized as a public health problem and presents a clinical challenge. This review critically summarizes available evidence on the burden, etiology, diagnosis, and practical management strategies for hyperglycemia in the ED. RECENT FINDINGS: Diabetic ketoacidosis (DKA) and hyperglycemic hyperosmolar state (HHS) are hyperglycemic emergencies that commonly present to the ED. However, the most common form of hyperglycemia in ED is associated with non-hyperglycemic medical emergencies...
August 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28645215/upper-extremity-trauma-resulting-from-agricultural-accidents-mechanism-and-severity-for-patients-with-and-without-upper-extremity-injury
#2
Louis C Grandizio, Benjamin Wagner, Jove Graham, Joel C Klena
BACKGROUND: Farming remains the most dangerous occupation in the United States and upper extremity (UE) injuries occur frequently in agricultural accidents. The purpose of this study is to describe the injury mechanisms, severity, and health care costs of UE injuries resulting from agricultural accidents and to compare patients with and without injuries to the UE. METHODS: We performed a 6-year retrospective review of our level I trauma center registry from January 2006 to May 2013, identifying all patients injured in an agricultural accident...
June 1, 2017: Hand: Official Journal of the American Association for Hand Surgery
https://www.readbyqxmd.com/read/28645119/the-application-of-enhanced-recovery-after-surgery-eras-fast-track-surgery-in-gastrectomy-for-gastric-cancer-a-systematic-review-and-meta-analysis
#3
REVIEW
Jie Ding, Benlong Sun, Peng Song, Song Liu, Hong Chen, Min Feng, Wenxian Guan
BACKGROUND: The study aimed to compare the safety and effectiveness of Enhanced recovery after surgery (ERAS) with conventional care in gastrectomy for gastric cancer. METHODS: Search strategy from Pubmed, Embase, Web of science, Cochrane library and reference lists was performed. The collected studies were randomized controlled trials and published only in English, and undergoing ERAS in gastrectomy for gastric cancer from January 1994 to August 2016. RESULTS: A total of eight studies including 801 patients were included...
June 20, 2017: Oncotarget
https://www.readbyqxmd.com/read/28644179/improving-heart-failure-patient-outcomes-utilizing-guideline-directed-therapy
#4
Beth Towery Davidson, Terri Lynn Allison
Heart failure (HF) prevalence continues to rise and remains a significant burden to patients, caregivers, providers, and the healthcare system. Guideline-directed medical therapy with standard neurohormonal blockade has been the cornerstone of medical management for many years. Despite aggressive utilization of angiotensin-converting enzyme inhibitors, angiotensin receptor blockers, beta-blockers, and aldosterone antagonists, HF hospitalizations and readmissions are common and residual mortality remains high...
July 21, 2017: Nurse Practitioner
https://www.readbyqxmd.com/read/28644118/insurance-mandated-stay-prolongs-hospitalization-following-total-shoulder-arthroplasty
#5
Krysten M Bell, Mark E Mildren, Montri D Wongworawat, Torrey Parry, Christopher M Jobe, Wesley P Phipatanakul
Medicare currently requires a 3-night hospitalization for a patient to be considered for skilled nursing facility (SNF) placement. The purpose of this study was to analyze the relationship between length of stay and (a) insurance status and (b) readmission rates in Medicare-age patients undergoing primary total shoulder arthroplasty. A retrospective review of 251 primary consecutive total shoulder arthroplasty cases was performed. In patients discharged to SNF, Medicare insurance was associated with a significantly longer hospital stay (p < ...
2017: Journal of Surgical Orthopaedic Advances
https://www.readbyqxmd.com/read/28643147/the-perioperative-surgical-home-improving-the-value-and-quality-of-care-in-total-joint-replacement
#6
REVIEW
George F Chimento, Leslie C Thomas
PURPOSE OF REVIEW: The perioperative surgical home (PSH) is a patient-centered, physician-led, multidisciplinary care pathway developed to deliver value-based care based on shared decision-making. Physician and hospital reimbursement will be tied to providing quality care at lower cost, and the PSH model has been used in providing care to patients undergoing lower extremity arthroplasty. The purpose of this review is to discuss the rationale, definition, development, current state, and future direction of the PSH...
June 22, 2017: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/28642333/patients-and-providers-perceptions-of-the-preventability-of-hospital-readmission-a-prospective-observational-study-in-four-european-countries
#7
Louise S van Galen, Mikkel Brabrand, Tim Cooksley, Peter M van de Ven, Hanneke Merten, Ralph Kl So, Loes van Hooff, Harm R Haak, Rachel M Kidney, Christian H Nickel, John Ty Soong, Immo Weichert, Mark Hh Kramer, Christian P Subbe, Prabath Wb Nanayakkara
OBJECTIVES: Because of fundamental differences in healthcare systems, US readmission data cannot be extrapolated to the European setting: To investigate the opinions of readmitted patients, their carers, nurses and physicians on predictability and preventability of readmissions and using majority consensus to determine contributing factors that could potentially foresee (preventable) readmissions. DESIGN: Prospective observational study. Readmitted patients, their carers, and treating professionals were surveyed during readmission to assess the discharge process and the predictability and preventability of the readmission...
June 22, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28642218/the-effectiveness-of-information-technology-supported-shared-care-for-patients-with-chronic-disease-a-systematic-review
#8
Laura Kooij, Wim G Groen, Wim H van Harten
BACKGROUND: In patients with chronic disease, many health care professionals are involved during treatment and follow-up. This leads to fragmentation that in turn may lead to suboptimal care. Shared care is a means to improve the integration of care delivered by various providers, specifically primary care physicians (PCPs) and specialty care professionals, for patients with chronic disease. The use of information technology (IT) in this field seems promising. OBJECTIVE: Our aim was to systematically review the literature regarding the effectiveness of IT-supported shared care interventions in chronic disease in terms of provider or professional, process, health or clinical and financial outcomes...
June 22, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28642086/geographical-outcome-disparities-in-infection-occurrence-after-colorectal-surgery
#9
Nasser Bagheri, Luis Furuya-Kanamori, Suhail A R Doi, Archie C A Clements, Art Sedrakyan
BACKGROUND: Despite improved surgical practices and in-hospital surveillance systems, surgical site infections remain a major public health problem worldwide and often require readmission to hospital. The aim was to apply an advance and innovative spatial analysis approach to identify spatial pattern and clustering (hotspots) of surgical site infection rate (CSIR), and quantifying disparities across communities. METHODS: We used the Admitted Patient Data Collection for patients aged 18 years and over who underwent colorectal surgery in a public hospital between 2002 and 2013 in the Australian State of New South Wales (NSW)...
June 19, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28641999/effect-of-pharmacist-care-on-medication-adherence-and-cardiovascular-outcomes-among-patients-post-acute-coronary-syndrome-a%C3%A2-systematic-review
#10
REVIEW
Maguy Saffouh El Hajj, Myriam Jihad Jaam, Ahmed Awaisu
BACKGROUND: The impact of collaborative and multidisciplinary health care on the outcomes of care in patients with acute coronary syndromes (ACS) is well-established in the literature. However, there is lack of high quality evidence on the role of pharmacist care in this setting. OBJECTIVE: This systematic review aimed to evaluate the impact of pharmacist care on patient outcomes (readmission, mortality, emergency visits, and medication adherence) in patients with ACS at or post-discharge...
June 13, 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28641831/two-components-of-the-new-espen-diagnostic-criteria-for-malnutrition-are-independent-predictors-of-lung-function-in-hospitalized-patients-with-chronic-obstructive-pulmonary-disease-copd
#11
Arora Ros Ingadottir, Anne Marie Beck, Christine Baldwin, C Elizabeth Weekes, Olof Gudny Geirsdottir, Alfons Ramel, Thorarinn Gislason, Ingibjorg Gunnarsdottir
INTRODUCTION: Low fat free mass index (FFMI) is a component of the ESPEN diagnosis criteria of malnutrition, that only when accompanied with weight loss is considered to be a determinant of malnutrition. Our aims were to assess the prevalence of malnutrition in patients with chronic obstructive pulmonary disease (COPD) applying the ESPEN criteria, and to examine the ability of different components of the criteria to predict COPD severity, length of stay (LOS), hospital readmissions within 30 days and mortality...
June 8, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28640768/perceptions-of-cardiology-administrators-about-cardiac-rehabilitation-in-south-america-and-the-caribbean
#12
Gabriela Lima de Melo Ghisi, Raquel Britto, Thaianne Cavalcante Servio, Claudia Victoria Anchique Santos, Rosalia Fernandez, Eduardo Rivas-Estany, Claudio Santibañez, Graciela Gonzalez, Gerard Burdiat, Francisco Lopez-Jimenez, Artur Haddad Herdy, Sherry L Grace
BACKGROUND: Cardiac rehabilitation (CR) programs can address the cardiovascular disease epidemic in South America. However, there are factors limiting CR access at the patient, provider, and system levels. The latter 2 have not been extensively studied. The objective of this study was to investigate cardiology administrator's awareness and knowledge of CR and perceptions regarding resources for CR. METHODS: This study was cross-sectional and observational in design...
July 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28638566/necessity-is-the-mother-of-invention-an-innovative-hospitalist-resident-initiative-for-improving-quality-and-reducing-readmissions-from-skilled-nursing-facilities
#13
Sunny Petigara, Mahesh Krishnamurthy, David Livert
Background: Hospital readmissions have been a major challenge to the US health system. Medicare data shows that approximately 25% of Medicare skilled nursing facility (SNF) residents are readmitted back to the hospital within 30 days. Some of the major reasons for high readmission rates include fragmented information exchange during transitions of care and limited access to physicians round-the-clock in SNFs. These represent safety, quality, and health outcome concerns. Aim: The goal of the project was to reduce hospital readmission rates from SNFs by improving transition of care and increasing physician availability in SNFs (five to seven days a week physical presence with 24/7 accessibility by phone)...
March 2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/28638496/effect-of-early-follow-up-after-hospital-discharge-on-outcomes-in-patients-with-heart-failure-or-chronic-obstructive-pulmonary-disease-a-systematic-review
#14
(no author information available yet)
BACKGROUND: Transitions in care can increase patients' vulnerability to adverse events. In particular, patients admitted for heart failure or chronic obstructive pulmonary disorder (COPD) have high rates of readmission and return emergency department visits. Heart failure patients have the highest 30-day readmission rates in Canada, and COPD patients comprise the highest volume of readmissions. Combined, these two conditions account for the largest number of emergency department returns...
2017: Ontario Health Technology Assessment Series
https://www.readbyqxmd.com/read/28637771/medicare-advantage-associated-with-more-racial-disparity-than-traditional-medicare-for-hospital-readmissions
#15
Yue Li, Xi Cen, Xueya Cai, Caroline P Thirukumaran, Jie Zhou, Laurent G Glance
We compared racial disparities in thirty-day readmissions between traditional Medicare and Medicare Advantage beneficiaries who underwent one of six major surgeries in New York State in 2013. We found that Medicare Advantage was associated with greater racial disparity, compared to traditional Medicare. After controlling for patient, hospital, and geographic characteristics in a propensity score based approach, we found that in traditional Medicare, black patients were 33 percent more likely than white patients to be readmitted, whereas in Medicare Advantage, black patients were 64 percent more likely than white patients to be readmitted...
June 21, 2017: Health Affairs
https://www.readbyqxmd.com/read/28637590/evaluation-of-readmissions-due-to-surgical-site-infections-a-potential-target-for-quality-improvement
#16
Romil Shah, Emily Pavey, Mila Ju, Ryan Merkow, Ravi Rajaram, Michael W Wandling, Mark E Cohen, Allison Dahlke, Anthony Yang, Karl Bilimoria
INTRODUCTION: Readmissions have become a focus of pay-for-performance programs. Surgical site infections (SSI) are the reason for most readmissions. Readmissions for SSI could be a unique target for quality improvement. METHODS: Readmission risk for SSI were evaluated for patients undergoing colectomies from 2013 to 2014. Hazard models were developed to examine factors associated with and hospital-level variation in risk-adjusted rates of readmission for SSI. RESULTS: Among 59,088 patients at 525 hospitals, the rate of readmissions for SSI ranged from 1...
June 8, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28637558/travel-time-influences-readmission-risk-geospatial-mapping-of-surgical-readmissions
#17
Florence E Turrentine, Patrick J Buckley, Min-Woong Sohn, Michael D Williams
The University of Virginia (UVA) has recently become an Accountable Care Organization (ACO), intensifying efforts to provide better care for individuals. UVA's ACO population resides across the entire Commonwealth, with a large percentage of patients living in rural areas. To provide better health for this population, the central tenet of the ACO mission, we identified geographic risk factors influencing hospital readmission. We analyzed the relationship between the distance of patients' residence to the nearest hospital and 30-day readmission in general surgery patients...
June 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28634502/impact-of-neurological-follow-up-on-early-hospital-readmission-rates-for-acute-ischemic-stroke
#18
Alexander Allen, Todd Barron, Ashley Mo, Richard Tangel, Ruth Linde, Rodney Grim, John Mingle, Ellen Deibert
INTRODUCTION: Despite advances in stroke care, readmission rates for patients with ischemic stroke remain high. Although factors such as age, diabetes, and continuous use of antiplatelet agents have been found to predict readmission rates, the impact of after-hospital care has not been examined. METHODS: The present study reviewed the charts of 416 patients with acute ischemic stroke and recorded stroke-related comorbidities, neurology follow-up within 21 days, readmission at 0 to 30 days, readmission at 31 to 90 days, and any reasons for readmission...
July 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28634037/clinical-benefit-of-drugs-targeting-mitochondrial-function-as-an-adjunct-to-reperfusion-in-st-segment-elevation-myocardial-infarction-a-meta-analysis-of-randomized-clinical-trials
#19
Gianluca Campo, Rita Pavasini, Giampaolo Morciano, A Michael Lincoff, C Michael Gibson, Masafumi Kitakaze, Jacob Lonborg, Amrita Ahluwalia, Hideki Ishii, Michael Frenneaux, Michel Ovize, Marcello Galvani, Dan Atar, Borja Ibanez, Giampaolo Cerisano, Simone Biscaglia, Brandon J Neil, Masanori Asakura, Thomas Engstrom, Daniel A Jones, Dana Dawson, Roberto Ferrari, Paolo Pinton, Filippo Ottani
AIMS: To perform a systematic review and meta-analysis of randomized clinical trials (RCT) comparing the effectiveness of drugs targeting mitochondrial function vs. placebo in patients with ST-segment elevation myocardial infarction (STEMI) undergoing mechanical coronary reperfusion. METHODS: Inclusion criteria: RCTs enrolling STEMI patients treated with primary percutaneous coronary intervention (PCI) and comparing drugs targeting mitochondrial function vs. placebo...
June 13, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28633658/nucleated-red-blood-cells-critical-illness-survivors-and-postdischarge-outcomes-a-cohort-study
#20
Steven W Purtle, Clare M Horkan, Takuhiro Moromizato, Fiona K Gibbons, Kenneth B Christopher
BACKGROUND: Little is known about risk factors associated with out-of-hospital outcomes in survivors of critical illness. We hypothesized that the presence of nucleated red blood cells in patients who survived critical care would be associated with adverse outcomes following hospital discharge. METHODS: We performed a two-center observational cohort study of patients treated in medical and surgical intensive care units in Boston, Massachusetts. All data were obtained from the Research Patient Data Registry at Partners HealthCare...
June 21, 2017: Critical Care: the Official Journal of the Critical Care Forum
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