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https://www.readbyqxmd.com/read/28731601/telephone-delivered-weight-management-services-in-the-hospital-outpatient-setting-decision-makers-perceptions-of-their-use-in-routine-practice
#1
Megan E Whelan, Ana D Goode, Ingrid J Hickman, Elizabeth G Eakin, Marina M Reeves
AIM: Providing effective weight management services to the growing number of overweight or obese hospital patients necessitates long-term service provision; however, it is arguably not within the acute-care hospital remit to provide such extended services. Referral to community-based programs is required to provide continuing weight management services. The Get Healthy Service is a free six-month, telephone-delivered lifestyle program, now offered in several states of Australia with potential for wide population reach...
July 2017: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
https://www.readbyqxmd.com/read/28730407/venous-thromboembolism-thrombosis-inflammation-and-immunothrombosis-for-clinicians
#2
REVIEW
Eduardo Vazquez-Garza, Carlos Jerjes-Sanchez, Aline Navarrete, Jorge Joya-Harrison, David Rodriguez
Venous thromboembolism (VTE) is a worldwide disease related with mortality, cardiovascular disability, impaired quality of life and, cause major long-term complications. Clinicians related to the acute and long-term patients care must be involved in the molecular mechanisms of thrombosis. The vessel wall and its inner lining of the endothelium are critical to the maintenance of a patent vasculature. After endothelial disruption, collagen (first line of endothelial defense) and intravascular tissue factor (second line of endothelial defense) are exposed to blood flow, starting the formation of a thrombus...
July 20, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/28730332/-a%C3%A2-phase-model-of-trauma-rehabilitation-how-can-we-avoid-the-rehab-hole
#3
Stefan Simmel, Wolf-Dieter Müller, Christoph Reimertz, Christian Kühne, Jean-Jacques Glaesener
Advances in the rescue chain and first aid of polytrauma patients, which have consequently increased their chance of survival, have led to an increase in demands for rehabilitation. However, there is still a large hole in the continuity of rehabilitation between acute patient care and in-patient rehabilitation, the so-called "rehab-hole". The consequences are untapped rehabilitation potential, loss of strength, endurance and motivation as well as impairment of function of the patient.Based on the phase model of neurological/neurosurgical rehabilitation, we propose a step model for the rehabilitation of polytrauma patients that ensures an uninterrupted chain of rehabilitation...
July 20, 2017: Der Unfallchirurg
https://www.readbyqxmd.com/read/28727607/new-onset-heart-failure-and-mortality-in-hospital-survivors-of-sepsis-related-left-ventricular-dysfunction
#4
Saraschandra Vallabhajosyula, Jacob C Jentzer, Jeffrey B Geske, Mukesh Kumar, Ankit Sakhuja, Akhil Singhal, Joseph T Poterucha, Kianoush Kashani, Joseph G Murphy, Ognjen Gajic, Rahul Kashyap
BACKGROUND: The association between new-onset left ventricular (LV) dysfunction during sepsis with long-term heart failure outcomes is lesser understood. METHODS: Retrospective cohort study of all adult patients with severe sepsis and septic shock between 2007 and 2014 that underwent echocardiography within 72 hours admitted to the intensive care unit. Patients with prior heart failure, LV dysfunction, and structural heart disease were excluded. LV systolic dysfunction was defined as LV ejection fraction <50% and LV diastolic dysfunction as ≥grade II...
July 19, 2017: Shock
https://www.readbyqxmd.com/read/28726539/rethinking-transitions-of-care-an-interprofessional-transfer-triage-protocol-in-post-acute-care
#5
Radha V Patel, Lauri Wright, Brittany Hay
Readmissions to hospitals from post-acute care (PAC) units within long-term care settings have been rapidly increasing over the past decade, and are drivers of increased healthcare costs. With an average of $11,000 per admission, there is a need for strategies to reduce 30-day preventable hospital readmission rates. In 2018, incentives and penalties will be instituted for long-term care facilities failing to meet all-cause, all-condition hospital readmission rate performance measures. An interprofessional team (IPT) developed and implemented a Transfer Triage Protocol used in conjunction with the INTERACT programme to enhance clinical decision-making and assess the potential to reduce the facility's 30-day preventable hospital readmission rates by 10% within 6 weeks of implementation...
July 20, 2017: Journal of Interprofessional Care
https://www.readbyqxmd.com/read/28718340/characterization-of-sepsis-and-sepsis-associated-encephalopathy
#6
Qing Feng, Yu-Hang Ai, Hua Gong, Long Wu, Mei-Lin Ai, Song-Yun Deng, Li Huang, Qian-Yi Peng, Li-Na Zhang
BACKGROUND: Sepsis and sepsis-associated encephalopathy (SAE) are common intensive care unit (ICU) diseases; the morbidity and mortality are high. The present study analyzed the sensitivity of different diagnostic criteria of sepsis 1.0 and 3.0, epidemiological characteristics of sepsis and SAE, and explored its risk factors for death, short-term, and long-term prognosis. METHODS: The retrospective study included patients in ICU from January 2015 to June 2016. After excluding 58 patients, 175 were assigned to either an SAE or a non-SAE group (patients with sepsis but no encephalopathy)...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28714184/research-review-what-have-we-learned-about-adolescent-substance-use
#7
REVIEW
Kevin M Gray, Lindsay M Squeglia
BACKGROUND: Adolescence is a critical biological, psychological, and social developmental stage involving heightened risk for substance use and associated adverse consequences. This review, synthesizing emerging findings on this complex topic, is intended to inform research and clinical care focused on adolescents. METHODS: Literature searches were conducted using PubMed, yielding a cross-section of observational and interventional studies focused on adolescent substance use...
July 17, 2017: Journal of Child Psychology and Psychiatry, and Allied Disciplines
https://www.readbyqxmd.com/read/28710987/the-long-term-quality-of-life-in-patients-with-persistent-inflammation-immunosuppression-and-catabolism-syndrome-after-severe-acute-pancreatitis-a-retrospective-cohort-study
#8
Na Yang, Baiqiang Li, Bo Ye, Lu Ke, Faxi Chen, Guotao Lu, Fangfang Jiang, Zhihui Tong, Jieshou Li, Weiqin Li
PURPOSE: To explore clinical characteristics and long-term quality of life (QOL) in severe acute pancreatitis (SAP) patients with persistent inflammation-immunosuppression and catabolism syndrome (PICS). MATERIALS AND METHODS: SAP patients admitted to ICU were eligible for the retrospective cohort study if they needed prolonged intensive care (>14days). Post-ICU QOL was assessed by a questionnaire, including 36-item Short Form Health Survey (SF-36) and record of re-work in a long-term follow-up...
July 8, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28706585/atrial-tachyarrhythmia-in-adult-congenital-heart-disease
#9
REVIEW
Arsha Karbassi, Krishnakumar Nair, Louise Harris, Rachel M Wald, S Lucy Roche
The adult congenital heart disease (ACHD) population continues to grow and most cardiologists, emergency room physicians and family doctors will intermittently come into contact with these patients. Oftentimes this may be in the setting of a presentation with atrial tachyarrhythmia; one of the commonest late complications of ACHD and problem with potentially serious implications. Providing appropriate initial care and ongoing management of atrial tachyarrhythmia in ACHD patients requires a degree of specialist knowledge and an awareness of certain key issues...
June 26, 2017: World Journal of Cardiology
https://www.readbyqxmd.com/read/28703869/early-supported-discharge-services-for-people-with-acute-stroke
#10
REVIEW
Peter Langhorne, Satu Baylan
BACKGROUND: People with stroke conventionally receive a substantial part of their rehabilitation in hospital. Services have now been developed that offer people in hospital an early discharge with rehabilitation at home (early supported discharge: ESD). OBJECTIVES: To establish if, in comparison with conventional care, services that offer people in hospital with stroke a policy of early discharge with rehabilitation provided in the community (ESD) can: 1) accelerate return home, 2) provide equivalent or better patient and carer outcomes, 3) be acceptable satisfactory to patients and carers, and 4) have justifiable resource implications use...
July 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28703290/the-association-between-peri-operative-acute-risk-change-arc-and-long-term-survival-after-cardiac-surgery
#11
T G Coulson, M Bailey, C M Reid, L Tran, D V Mullany, J A Smith, D Pilcher
Acute risk change has been described as the difference in calculated mortality risk between the pre-operative and postoperative periods of cardiac surgery. We aimed to assess whether this was associated with long-term survival after cardiac surgery. We retrospectively analysed 22,570 cardiac surgical patients, with minimum and maximum follow-up of 1.0 and 6.7 years. Acute risk change was calculated as the arithmetic difference between pre- and postoperative mortality risk. 'Rising risk' represented an increase in risk from pre- to postoperative phase...
July 13, 2017: Anaesthesia
https://www.readbyqxmd.com/read/28701496/the-spectrum-of-mild-traumatic-brain-injury-a-review
#12
REVIEW
Andrew R Mayer, Davin K Quinn, Christina L Master
OBJECTIVE: This review provides an in-depth overview of diagnostic schema and risk factors influencing recovery during the acute, subacute (operationally defined as up to 3 months postinjury), and chronic injury phases across the full spectrum of individuals (e.g., athletes to neurosurgery patients) with mild traumatic brain injury (mTBI). Particular emphasis is placed on the complex differential diagnoses for patients with prolonged postconcussive symptoms. METHODS: Select literature review and synthesis...
July 12, 2017: Neurology
https://www.readbyqxmd.com/read/28701028/psychological-interventions-for-acute-pain-after-open-heart-surgery
#13
REVIEW
Susanne Ziehm, Jenny Rosendahl, Jürgen Barth, Bernhard M Strauss, Anja Mehnert, Susan Koranyi
BACKGROUND: This is an update of a Cochrane review previously published in 2014. Acute postoperative pain is one of the most disturbing complaints in open heart surgery, and is associated with a risk of negative consequences. Several trials investigated the effects of psychological interventions to reduce acute postoperative pain and improve the course of physical and psychological recovery of participants undergoing open heart surgery. OBJECTIVES: To compare the efficacy of psychological interventions as an adjunct to standard care versus standard care alone or standard care plus attention control in adults undergoing open heart surgery for pain, pain medication, psychological distress, mobility, and time to extubation...
July 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28700753/acute-kidney-injury-after-cardiac-surgery-is-associated-with-mid-term-but-not-long-term-mortality-a-cohort-based-study
#14
Alejandro Ferreiro, Raúl Lombardi
Acute kidney injury (AKI) in cardiac surgery is associated with complications, early and late mortality and increased health care expenditures. The overall dynamic comorbidity-adjusted contributions of an episode of AKI on mortality during long-term follow-up have not been fully explored. A longitudinal cohort of 7075 adult patients admitted for cardiac surgery were enrolled in the study. Follow-up data were obtained through telephonic survey after 1, 5, 10, and 15 years or from the National Mortality Registry...
2017: PloS One
https://www.readbyqxmd.com/read/28697503/update-of-sepsis-in-the-intensive-care-unit
#15
Kelly Roveran Genga, James A Russell
Sepsis, the most common cause of admission to an intensive care unit (ICU), has had an increased incidence and prevalence over the last years with a simultaneous decrease in its short-term mortality. Sepsis survivors are more frequently discharged from hospital and often experience long-term outcomes such as late mortality, immune dysfunction, secondary infections, impaired quality of life, and unplanned readmissions. Early recognition and management of sepsis have challenged emergency care and critical care physicians and nurses...
July 12, 2017: Journal of Innate Immunity
https://www.readbyqxmd.com/read/28697289/bariatric-metabolic-surgery-a-guide-for-the-primary-care-physician
#16
Phong Ching Lee, John Dixon
BACKGROUND: Bariatric-metabolic surgery has emerged as an attractive option that offers significant and durable weight loss in the treatment of clinically severe obesity. Given the high prevalence of obesity, and growing numbers of bariatric-metabolic surgeries performed, primary care physicians increasingly encounter patients who have had, or are considering, bariatric-metabolic surgery. OBJECTIVE: The aim of this article is to provide guidance on common issues pertaining to bariatric-metabolic surgery that general practitioners (GPs) face, including patient selection, preoperative work-up, acute and long-term complications following the surgery, and long-term lifestyle and nutritional support...
2017: Australian Family Physician
https://www.readbyqxmd.com/read/28694251/advances-in-the-causes-and-management-of-community-acquired-pneumonia-in-adults
#17
REVIEW
Richard G Wunderink, Grant Waterer
Community acquired pneumonia remains a common cause of morbidity and mortality. Usually, the causal organism is not identified and treatment remains empiric. Recent computed tomography and magnetic resonance imaging studies have challenged the accuracy of the clinical diagnosis of pneumonia, and epidemiologic studies are changing our perspective of what causes community acquired pneumonia, especially the role of viral pathogens and the frequent finding of multiple pathogens. The past decade has seen increasing overuse of empiric coverage of meticillin resistant Staphylococcus aureus and antibiotic resistant Gram negative pathogens owing to inappropriate application of guidelines for healthcare associated pneumonia...
July 10, 2017: BMJ: British Medical Journal
https://www.readbyqxmd.com/read/28693636/acquisition-of-clostridium-difficile-colonization-and-infection-after-transfer-from-a-veterans-affairs-hospital-to-an-affiliated-long-term-care-facility
#18
Suresh Ponnada, Dubert M Guerrero, Lucy A Jury, Michelle M Nerandzic, Jennifer L Cadnum, M Jahangir Alam, Curtis J Donskey
BACKGROUND Clostridium difficile infection (CDI) and asymptomatic carriage of toxigenic C. difficile are common in long-term care facilities (LTCFs). However, whether C. difficile is frequently acquired in the LTCF versus during acute-care admissions remains unknown. OBJECTIVE To test the hypothesis that LTCF residents often acquire C. difficile colonization and infection in the LTCF DESIGN This 5-month cohort study was conducted to determine the incidence of acquisition of C. difficile colonization and infection in asymptomatic patients transferred from a Veterans Affairs hospital to an affiliated LTCF...
July 11, 2017: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/28693604/right-median-nerve-electrical-stimulation-for-acute-traumatic-coma-the-asia-coma-electrical-stimulation-trial-study-protocol-for-a-randomised-controlled-trial
#19
Xiang Wu, Chao Zhang, Junfeng Feng, Qing Mao, Guoyi Gao, Jiyao Jiang
BACKGROUND: Traumatic brain injury (TBI) has become the most common cause of death and disability in persons between 15 and 30 years of age, and about 10-15% of patients affected by TBI will end up in a coma. Coma caused by TBI presents a significant challenge to neuroscientists. Right median nerve electrical stimulation has been reported as a simple, inexpensive, non-invasive technique to speed recovery and improve outcomes for traumatic comatose patients. METHODS/DESIGN: This multicentre, prospective, randomised (1:1) controlled trial aims to demonstrate the efficacy and safety of electrical right median nerve stimulation (RMNS) in both accelerating emergence from coma and promoting long-term outcomes...
July 10, 2017: Trials
https://www.readbyqxmd.com/read/28693340/quality-of-care-and-its-impact-on-one-year-mortality-the-georgia-coverdell-acute-stroke-registry
#20
Moges S Ido, Michael R Frankel, Ike S Okosun, Richard B Rothenberg
Although performance measures help monitor the process change in quality improvement, their utility in measuring long-term outcomes is uncertain. This study assessed the 1-year mortality of acute ischemic stroke patients treated by hospitals participating in the Georgia Coverdell Acute Stroke Registry. Using 10 nationally approved performance measures, quality of care was defined both as an all-or-none measure (defect-free care) and as a composite index. A generalized estimating equation was applied to assess the effect of quality of care on 1-year mortality...
March 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
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