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https://www.readbyqxmd.com/read/28685387/postoperative-abdominal-adhesions-clinical-significance-and-advances-in-prevention-and-management
#1
Demetrios Moris, Jeffery Chakedis, Amir A Rahnemai-Azar, Ana Wilson, Mairead Marion Hennessy, Antonios Athanasiou, Eliza W Beal, Chrysoula Argyrou, Evangelos Felekouras, Timothy M Pawlik
Postoperative adhesions remain one of the more challenging issues in surgical practice. Although peritoneal adhesions occur after every abdominal operation, the density, time interval to develop symptoms, and clinical presentation are highly variable with no predictable patterns. Numerous studies have investigated the pathophysiology of postoperative adhesions both in vitro and in vivo. Factors such as type and location of adhesions, as well as timing and recurrence of adhesive obstruction remain unpredictable and poorly understood...
July 6, 2017: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/28673874/post-operative-outcomes-after-single-port-laparoscopic-removal-of-adnexal-masses-in-patients-referred-to-gynecologic-oncology-at-a-large-academic-center
#2
Laura J Moulton, Amelia M Jernigan, Chad M Michener
OBJECTIVE: To report surgical and pathologic outcomes after single port laparoscopy (SPL) for adnexal masses in patients referred to a gynecologic oncology practice at a single academic institution. DESIGN: Retrospective analysis (Canadian Task Force Classification II.2). SETTING: A single academic institution with multiple hospital centers PATIENTS: Women who underwent at least one single port laparoscopic surgery for treatment of an adnexal mass from 2009-2015 after referral to a gynecologic oncology practice...
June 30, 2017: Journal of Minimally Invasive Gynecology
https://www.readbyqxmd.com/read/28657819/cares-a-community-wide-collaboration-identifies-super-utilizers-and-reduces-their-9-1-1-call-emergency-department-and-hospital-visit-rates
#3
E Stein Bronsky, Constance McGraw, Robin Johnson, Kristin Giordano, Alessandro Orlando, David Bar-Or
BACKGROUND: A subset of individuals who inefficiently and frequently use emergency department (ED) services are called "super-utilizers." Our healthcare system is fragmented and complex, making it difficult for providers to identify super-utilizers and address their wide range of health issues. OBJECTIVE: The objective of our study was to evaluate a novel community-wide collaboration program called CARES (Community Assistance Referral and Education Services) designed to identify super-utilizers through local partnering organizations...
June 28, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28646567/severe-menses-associated-hypertension-successfully-treated-with-gonadotropin-releasing-hormone-agonist
#4
Luke J Laffin, Munnam S Jafar, George L Bakris
A case of a 32-year-old nulliparous white woman referred for a 5-year history of severe hypertension, hypokalemia, and resultant systolic dysfunction is presented. She additionally had a left ventricular ejection fraction of 30% including left ventricular dilation and normal left ventricular mass index, as measured by cardiac magnetic resonance imaging when she initially presented to us. Her history revealed that her severe hypertension episodes were monthly and would occur around the catamenial (menses-associated) time...
June 23, 2017: Journal of Clinical Hypertension
https://www.readbyqxmd.com/read/28638518/automated-reporting-of-trainee-metrics-using-electronic-clinical-systems
#5
Jonathan C Levin, Jonathan Hron
BACKGROUND: The Accreditation Council for Graduate Medical Education has called for increased emphasis on reporting objective performance measures to trainees and programs. However, reporting of objective measures, including clinical volume, is largely omitted from training programs. OBJECTIVE: To use automated electronic medical systems at a tertiary pediatric care hospital to create a dashboard that reports objective trainee and program metrics, including clinical volume and diagnoses in a pediatrics residency...
June 2017: Journal of Graduate Medical Education
https://www.readbyqxmd.com/read/28637560/despite-trauma-center-closures-trauma-system-regionalization-reduces-mortality-and-time-to-definitive-care-in-severely-injured-patients
#6
Jack C He, David Schechtman, Debra L Allen, Jillian J Cremona, Jeffrey A Claridge
The Northern Ohio Trauma System (NOTS), consisting of multiple hospital systems, was established in 2010 to improve trauma outcomes. This study assessed its impact on mortality and time to definitive care, focusing especially on the severely injured patients. NOTS trauma registry was queried for all trauma activations from 2008 to 2013. The years between 2008-2009 and 2011-2013 were designated as pre- and post-NOTS, respectively. Data from 2010 was excluded as a transitional year. Two trauma centers (TCs) closed in 2010...
June 1, 2017: American Surgeon
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
#7
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
#8
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
#9
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
#10
MULTICENTER STUDY
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
#11
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
#12
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
#13
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
#14
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
#15
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
#16
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
#17
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
#18
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
#19
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
#20
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
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