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https://www.readbyqxmd.com/read/28630372/multitype-events-and-the-analysis-of-heart-failure-readmissions-illustration-of-a-new-modeling-approach-and-comparison-with-familiar-composite-end-points
#1
Paul M Brown, Justin A Ezekowitz
BACKGROUND: Heart failure-related hospital readmissions and mortality are often outcomes in clinical trials. Patients may experience multiple hospital readmissions over time with mortality acting as a dependent terminal event. Univariate composite end points are used for the analysis of readmissions. We may amend these approaches to include emergency department visits as a further outcome. An alternative multivariate modeling approach that categorizes hospital readmissions and emergency department visits as separate event types is proposed...
June 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28599290/early-postoperative-radiotherapy-is-associated-with-improved-outcomes-over-late-postoperative-radiotherapy-in-the-management-of-completely-resected-r0-stage-iiia-n2-non-small-cell-lung-cancer
#2
Huan-Huan Wang, Lei Deng, Qing-Lian Wen, Chun-Ze Zhang, Nicholas G Zaorsky, Bai-Lin Zhang, Jie Chen, Xian-Liang Zeng, Yao-Li Cui, Yang-Yang Shi, Hai-Ling Hou, Wei Wang, Bo Jiang, Jun Wang, Qing-Song Pang, Lu-Jun Zhao, Zhi-Yong Yuan, Ping Wang, Mao-Bin Meng
AIMS: The aim of this study was to evaluate the ideal timing of PORT in the management of completely resected (R0) Stage IIIA-N2 NSCLC. PATIENTS AND METHODS: Between January 2008 and December 2015, patients with known histologies of pathologic Stage IIIA-N2 NSCLC who underwent R0 resection and received PORT concurrent with or prior to two sequential cycles of chemotherapy ("early PORT") or with PORT administered after two cycles of chemotherapy ("late PORT") at multiple hospitals...
May 23, 2017: Oncotarget
https://www.readbyqxmd.com/read/28591172/multi-state-modelling-of-heart-failure-care-path-a-population-based-investigation-from-italy
#3
Francesca Gasperoni, Francesca Ieva, Giulia Barbati, Arjuna Scagnetto, Annamaria Iorio, Gianfranco Sinagra, Andrea Di Lenarda
BACKGROUND: How different risk profiles of heart failure (HF) patients can influence multiple readmissions and outpatient management is largely unknown. We propose the application of two multi-state models in real world setting to jointly evaluate the impact of different risk factors on multiple hospital admissions, Integrated Home Care (IHC) activations, Intermediate Care Unit (ICU) admissions and death. METHODS AND FINDINGS: The first model (model 1) concerns only hospitalizations as possible events and aims at detecting the determinants of repeated hospitalizations...
2017: PloS One
https://www.readbyqxmd.com/read/28562576/prevalence-trends-in-the-characteristics-of-patients-with-allergic-asthma-in-beijing-1994-to-2014
#4
Dan Mao, Rui Tang, Rui Wu, Hong Hu, Lu Jin Sun, Hong Zhu, Xue Bai, Jing Guo Han
This study aimed to determine the clinical profiles and prevalence trends during 1994 to 2014 among patients with allergic asthma (AA), which is a clinical phenotype of asthma.We retrospectively analyzed the characteristics of 319 patients who were diagnosed with AA between March 1, 1994 and February 28, 2014 at 3 Beijing centers.The patients included 155 males and 164 females, and the mean age was 50.86 ± 15.27 years (range 13-86 years). The proportions of asthma attacks in summer and autumn were 60.7% (1994-1999), 61...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28528221/bronchopulmonary-dysplasia-and-perinatal-characteristics-predict-1-year-respiratory-outcomes-in-newborns-born-at-extremely-low-gestational-age-a-prospective-cohort-study
#5
Roberta L Keller, Rui Feng, Sara B DeMauro, Thomas Ferkol, William Hardie, Elizabeth E Rogers, Timothy P Stevens, Judith A Voynow, Scarlett L Bellamy, Pamela A Shaw, Paul E Moore
OBJECTIVE: To assess the utility of clinical predictors of persistent respiratory morbidity in extremely low gestational age newborns (ELGANs). STUDY DESIGN: We enrolled ELGANs (<29 weeks' gestation) at ≤7 postnatal days and collected antenatal and neonatal clinical data through 36 weeks' postmenstrual age. We surveyed caregivers at 3, 6, 9, and 12 months' corrected age to identify postdischarge respiratory morbidity, defined as hospitalization, home support (oxygen, tracheostomy, ventilation), medications, or symptoms (cough/wheeze)...
May 17, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28499377/calculating-hospital-length-of-stay-using-the-hospital-episode-statistics-a-comparison-of-methodologies
#6
John Busby, Sarah Purdy, William Hollingworth
BACKGROUND: Accurate calculation of hospital length of stay (LOS) from the English Hospital Episode Statistics (HES) is important for a wide range of audit and research purposes. The two methodologies which are commonly used to achieve this differ in their accuracy and complexity. We compare these methods and make recommendations on when each is most appropriate. METHODS: We calculated LOS using continuous inpatient spells (CIPS), which link care spanning across multiple hospitals, and spells, which do not, for six conditions with short (dyspepsia or other stomach function, ENT infection), medium (dehydration and gastroenteritis, perforated or bleeding ulcer), and long (stroke, fractured proximal femur) average LOS...
May 12, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28456336/a-full-capacity-protocol-allows-for-increased-emergency-patient-volume-and-hospital-admissions
#7
Erin Willard, Elizabeth F Carlton, Lindsay Moffat, Bradley E Barth
Our hospital was encountering problems with ED crowding. We sought to determine the impact of implementing a full-capacity protocol to respond to anticipated or actual crowding conditions. Our full-capacity protocol is based on collaboration among multiple hospital units. METHODS: We completed a quality improvement initiative using a pre/post analysis of all ED patient encounters after implementing a full-capacity protocol with a corresponding period from the prior year. The principal outcomes measured were patient volume, admission rate, patient left without being seen (LWBS) rate, length of stay, and ambulance diversion hours...
April 26, 2017: Journal of Emergency Nursing: JEN: Official Publication of the Emergency Department Nurses Association
https://www.readbyqxmd.com/read/28432164/use-of-gabapentin-in-the-treatment-of-chronic-pain-in-an-adolescent-with-sickle-cell-disease
#8
Cátia R Correia, Ana Teresa Soares, Laura Azurara, Maria João Palaré
Vaso-occlusive crises are the most common manifestation of sickle cell disease (SCD) and the main cause of hospital admission in these patients. There is emerging evidence that vaso-occlusive pain has both nociceptive and neuropathic components. However, the treatment of SCD-related pain with neuropathic drugs has not yet been systematically studied, particularly in children. We describe a 14-year-old girl with SCD and multiple hospital admissions for pain management for severe acute vaso-occlusive pain episodes...
April 21, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28414679/misses-opportunity-tof-diagnoses-in-4th-decade-of-life
#9
O Baniahmad, T Jarreau, A Johnson
CASE: A 40 year old woman with a history of HIV, congestive heart failure secondary to an unknown congenital heart defect, and hypertension presented to our emergency department with worsening edema. On room air, oxygen saturation was 55 percent . On 5L of oxygen via nasal cannula, oxygen saturation was 88 percent . Physical examination was notable for central cyanosis, facial and lid edema, a II/VI holosystolic murmur across right chest radiating to entire right back hemithorax, decreased breath sounds at bases with pulmonary crackles, clubbing of fingers and edema of bilateral lower extremities...
March 2017: Journal of the Louisiana State Medical Society: Official Organ of the Louisiana State Medical Society
https://www.readbyqxmd.com/read/28407410/variable-clinical-course-of-identical-twin-neonates-with-alstr%C3%A3-m-syndrome-presenting-coincidentally-with-dilated-cardiomyopathy
#10
Seth A Hollander, Norah Alsaleh, Maura Ruzhnikov, Kristen Jensen, David N Rosenthal, David A Stevenson, Melanie Manning
Alström Syndrome (AS) is a rare autosomal recessive disorder caused by mutations in the ALMS1 gene. We report monozygotic twin infants who presented concurrently with symptoms of congestive heart failure (CHF) due to dilated cardiomyopathy (DCM). Following their initial presentation, one twin improved both echocardiographically and functionally while the other twin showed a progressive decline in ventricular function and worsening CHF symptoms requiring multiple hospitalizations and augmentation of heart failure therapy...
June 2017: American Journal of Medical Genetics. Part A
https://www.readbyqxmd.com/read/28399151/the-recent-emergence-in-hospitals-of-multidrug-resistant-community-associated-sequence-type-1-and-spa-type-t127-methicillin-resistant-staphylococcus-aureus-investigated-by-whole-genome-sequencing-implications-for-screening
#11
Megan R Earls, Peter M Kinnevey, Gráinne I Brennan, Alexandros Lazaris, Mairead Skally, Brian O'Connell, Hilary Humphreys, Anna C Shore, David C Coleman
Community-associated spa type t127/t922 methicillin-resistant Staphylococcus aureus (MRSA) prevalence increased from 1%-7% in Ireland between 2010-2015. This study tracked the spread of 89 such isolates from June 2013-June 2016. These included 78 healthcare-associated and 11 community associated-MRSA isolates from a prolonged hospital outbreak (H1) (n = 46), 16 other hospitals (n = 28), four other healthcare facilities (n = 4) and community-associated sources (n = 11). Isolates underwent antimicrobial susceptibility testing, DNA microarray profiling and whole-genome sequencing...
2017: PloS One
https://www.readbyqxmd.com/read/28385473/the-utility-of-repeat-culture-in-fungal-corneal-ulcer-management-a-secondary-analysis-of-the-mutt-i-randomized-clinical-trial
#12
Kathryn J Ray, Prajna Lalitha, N Venkatesh Prajna, Revathi Rajaraman, Tiruvengada Krishnan, Muthiah Srinivasan, Peter Ryg, Stephen McLeod, Nisha R Acharya, Thomas M Lietman, Jennifer Rose-Nussbaumer
PURPOSE: To determine whether patients who had a positive repeated culture was predictive of worse clinical outcome than those who achieved microbiological cure at 6 days in the Mycotic Ulcer Treatment Trial I (MUTT-I). DESIGN: Secondary analysis from a multicenter, double-masked, randomized clinical trial. METHODS: setting: Multiple hospital sites of the Aravind Eye Care System, India. STUDY POPULATION: Patients with culture-positive filamentous fungal ulcers and visual acuity of 20/40 to 20/400 reexamined 6 days after initiation of treatment...
June 2017: American Journal of Ophthalmology
https://www.readbyqxmd.com/read/28351702/effects-of-operational-decisions-on-the-diffusion-of-epidemic-disease-a-system-dynamics-modeling-of-the-mers-cov-outbreak-in-south-korea
#13
Nina Shin, Taewoo Kwag, Sangwook Park, Yon Hui Kim
We evaluated the nosocomial outbreak of Middle East Respiratory Syndrome (MERS) Coronavirus (CoV) in the Republic of Korea, 2015, from a healthcare operations management perspective. Establishment of healthcare policy in South Korea provides patients' freedom to select and visit multiple hospitals. Current policy enforces hospitals preference for multi-patient rooms to single-patient rooms, to lower financial burden. Existing healthcare systems tragically contributed to 186 MERS outbreak cases, starting from single "index patient" into three generations of secondary infections...
March 27, 2017: Journal of Theoretical Biology
https://www.readbyqxmd.com/read/28345011/cross-cultural-differences-of-the-non-motor-symptoms-studied-by-the-traditional-chinese-version-of-the-international-parkinson-and-movement-disorder-society-unified-parkinson-s-disease-rating-scale
#14
Rwei-Ling Yu, Ruey-Meei Wu, Anne Y Y Chan, Vincent Mok, Yih-Ru Wu, Barbara C Tilley, Sheng Luo, Lu Wang, Nancy R LaPelle, Glenn T Stebbins, Christopher G Goetz
BACKGROUND: Given the importance of ethnic differences in the evaluation of various aspects of symptoms in patients with Parkinson's disease (PD), we present the formal procedure for completing the traditional Chinese translation of the International and Parkinson and Movement Disorder Society/UPDRS (MDS-UPDRS) and highlight the discrepancy in nonmotor symptoms (NMS) between patients in Eastern and Western countries. METHODS: A total of 350 native Chinese-speaking PD patients were recruited from multiple hospitals in Eastern countries; they completed the MDS-UPDRS...
January 2017: Movement Disorders Clinical Practice
https://www.readbyqxmd.com/read/28342624/the-level-of-anxiety-depression-and-quality-of-life-among-patients-with-heart-failure-in-greece
#15
Zoi Aggelopoulou, Nikolaos V Fotos, Anastasia A Chatziefstratiou, Konstantinos Giakoumidakis, Ioannis Elefsiniotis, Hero Brokalaki
PURPOSE: The assessment of the level of anxiety, depression and quality of life among patients with heart failure. METHODS: It was an observational study. The populations were 231 patients with heart failure who were hospitalized in cardiology departments of 2 general hospitals in Athens, from September 1, 2010 through January 31, 2012. We used the "Minnesota Living with Heart Failure Questionnaire - MLHFQ" to evaluate patients' quality of life and the " State-Trait Anxiety Inventory - STAI" and the "Maastricht Questionnaire - MQ" to evaluate the level of stress and depression, respectively...
April 2017: Applied Nursing Research: ANR
https://www.readbyqxmd.com/read/28326914/so-you-think-you-ve-designed-an-effective-recruitment-protocol
#16
Cara Green, Virginia Vandall-Walker
Background Recruiting acutely ill patients to participate in research can be challenging. This paper outlines the difficulties the first author encountered in a study and the steps she took to overcome problems with research ethics, gain access to participants and implement a recruitment protocol in multiple hospitals. It also compares these steps with literature related to recruitment. Aim To inform and inspire neophyte researchers about the need for planning and resilience when dealing with recruitment challenges in multiple hospitals...
March 22, 2017: Nurse Researcher
https://www.readbyqxmd.com/read/28299558/body-pushing-prescription-drugs-and-hospital-admission
#17
Roger W Byard, Michaela Kenneally
A 39-year-old man died of multi-organ failure complicating mixed drug toxicity that included methadone, oxazepam, oxycodone and nitrazepam. His past medical history involved alcohol and poly-substance abuse with chronic self-harm and suicidal ideation. There had been multiple hospital admissions for drug overdoses. At autopsy the most unusual finding was of two packages of 10 tablets each, wrapped in thin plastic film within the rectum. The insertion of drugs into body orifices and cavities has been termed body pushing to distinguish it from body packing where illicit drugs are wrapped and swallowed for transport and smuggling, and body stuffing where small amounts of loosely wrapped or unwrapped drugs are swallowed to conceal evidence from police...
March 15, 2017: Forensic Science, Medicine, and Pathology
https://www.readbyqxmd.com/read/28287963/a-dataset-and-a-technique-for-generalized-nuclear-segmentation-for-computational-pathology
#18
Neeraj Kumar, Ruchika Verma, Sanuj Sharma, Surabhi Bhargava, Abhishek Vahadane, Amit Sethi
Nuclear segmentation in digital microscopic tissue images can enable extraction of high-quality features for nuclear morphometrics and other analysis in computational pathology. Conventional image processing techniques such as Otsu thresholding and watershed segmentation do not work effectively on challenging cases, such as chromatin-sparse and crowded nuclei. In contrast, machine learning-based segmentation can generalize across various nuclear appearances. However, training machine learning algorithms require datasets of images in which a vast number of nuclei have been annotated...
March 6, 2017: IEEE Transactions on Medical Imaging
https://www.readbyqxmd.com/read/28284254/tuberculosis-hospitalization-expenditures-per-patient-from-private-health-insurance-claims-data-2010-2014
#19
K Owusu-Edusei, S M Marks, R Miramontes, E L Stockbridge, C A Winston
OBJECTIVE: To determine hospitalization expenditures for tuberculosis (TB) disease among privately insured patients in the United States. METHODS: We extracted TB hospital admissions data from the 2010-2014 MarketScan® commercial database using International Classification of Diseases version 9 codes for TB (011.0-018.96) as the principal diagnosis. We estimated adjusted average expenditures (in 2014 USD) using regression analyses controlling for patient and claim characteristics...
April 1, 2017: International Journal of Tuberculosis and Lung Disease
https://www.readbyqxmd.com/read/28197216/introducing-the-comprehensive-unit-based-safety-program-for-mechanically-ventilated-patients-in-saudi-arabian-intensive-care-units
#20
Raymond M Khan, Maha Aljuaid, Hanan Aqeel, Mohammed M Aboudeif, Shaimaa Elatwey, Rajeh Shehab, Yasser Mandourah, Khalid Maghrabi, Hassan Hawa, Imran Khalid, Ismael Qushmaq, Asad Latif, Bickey Chang, Sean M Berenholtz, Sultan Tayar, Khloud Al-Harbi, Amin Yousef, Anas A Amr, Yaseen M Arabi
Over the past decade, there have been major improvements to the care of mechanically ventilated patients (MVPs). Earlier initiatives used the concept of ventilator care bundles (sets of interventions), with a primary focus on reducing ventilator-associated pneumonia. However, recent evidence has led to a more comprehensive approach: The ABCDE bundle (Awakening and Breathing trial Coordination, Delirium management and Early mobilization). The approach of the Comprehensive Unit-based Safety Program (CUSP) was developed by patient safety researchers at the Johns Hopkins Hospital and is supported by the Agency for Healthcare Research and Quality to improve local safety cultures and to learn from defects by utilizing a validated structured framework...
January 2017: Annals of Thoracic Medicine
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