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https://www.readbyqxmd.com/read/29044967/comparison-of-long-term-outcomes-of-50-mg-and-100-mg-rt-pa-in-the-management-of-acute-pulmonary-thromboembolism
#1
Elif Yilmazel Ucar, Omer Araz, Bugra Kerget, Nafiye Yilmaz, Metin Akgun, Leyla Saglam
BACKGROUND: Pulmonary thromboembolism (PTE) is a life-threatening disease. In this study, we aimed to evaluate long-term outcomes of the use of 50 mg recombinant tissue-type plasminogen activator (rt-PA) in the management of PTE in terms of relapse, pulmonary hypertension (PH), mortality and hemorrhage, and to compare with the use of 100 mg rt-PA. METHODS: The study was designed as a retrospective cohort. Patients who were diagnosed as acute PTE and received either 50 mg or 100 mg rt-PA in a tertiary care hospital between 2010 and 2015 were included in the study...
October 17, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/29043966/hospital-at-home-a-review-of-our-experience
#2
Edmond C Y U, Glyn A Pryor, Martyn J Parker
INTRODUCTION: Hospital at home (HAH) is a service that provides home-based nursing and rehabilitation services whose aim is to prevent admission or to facilitate early discharge from care in an acute hospital. METHODS: We evaluated the effectiveness of early discharge hospital at home (HAH) schemes for hip fracture patients over a 27-year period in a district general hospital in the United Kingdom. A long-term database for audit and research purposes is maintained for all hip fracture patients admitted to Peterborough City Hospital...
2017: SICOT-J
https://www.readbyqxmd.com/read/29042263/facility-level-factors-and-outcomes-after-skilled-nursing-facility-admission-for-trauma-and-surgical-patients
#3
Lucas W Thornblade, Saman Arbabi, David R Flum, Qian Qiu, Vanessa J Fawcett, Giana H Davidson
OBJECTIVE: Patients discharged to skilled nursing facilities (SNFs) have worse outcomes than those discharged to home, but whether this is due to differences in facility-level factors in addition to patient characteristics is not known. We aimed to determine whether SNF-level factors including nurse staffing and patient density are associated with outcomes after acute hospitalization for trauma or surgery. DESIGN, SETTING, PARTICIPANTS, AND MEASUREMENTS: Retrospective study of patients discharged to Medicare-certified SNFs after trauma or major surgery from 2007 to 2009...
October 14, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29041982/costs-related-to-cardiac-arrest-management-a-systematic-review-protocol
#4
Guillaume Geri, Joshua Gilgan, Carolyn Ziegler, Wanrudee Isaranuwatchai, Laurie J Morrison
BACKGROUND: Each year, about 500,000 people suffer a cardiac arrest (either out-of-hospital or in-hospital) in the USA. Although significant improvements in survival have occurred through the implementation of complex high-quality protocols of care, global costs related to such management are not clearly described. METHODS: We will undertake a systematic review of the published literature on costs related to the acute phase of cardiac arrest management (from collapse to hospital discharge)...
October 17, 2017: Systematic Reviews
https://www.readbyqxmd.com/read/29040678/extended-models-for-nosocomial-infection-parameter-estimation-and-model-selection
#5
Alun Thomas, Karim Khader, Andrew Redd, Molly Leecaster, Yue Zhang, Makoto Jones, Tom Greene, Matthew Samore
We consider extensions to previous models for patient level nosocomial infection in several ways, provide a specification of the likelihoods for these new models, specify new update steps required for stochastic integration, and provide programs that implement these methods to obtain parameter estimates and model choice statistics. Previous susceptible-infected models are extended to allow for a latent period between initial exposure to the pathogen and the patient becoming themselves infectious, and the possibility of decolonization...
October 12, 2017: Mathematical Medicine and Biology: a Journal of the IMA
https://www.readbyqxmd.com/read/29036629/nanotechnology-a-promising-new-paradigm-for-the-control-of-pain
#6
Krishnan V Chakravarthy, Frank J Boehm, Paul J Christo
Objective: The objective of this article is to critically review both preclinical and clinical studies that focus on the use of nanotechnology for both acute and chronic pain management, surveying both diagnostic and therapeutic applications. The article also provides information on nanotechnology for pain practitioners, so that they may better understand how this technology works and how it may be applied to their day-to-day clinical practice. Study Design: Narrative review...
June 27, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/29033779/a-patient-with-nafcillin-associated-drug-induced-liver-failure
#7
Qin Rao, Isaiah Schuster, Talal Seoud, Kevin Zarrabi, Nirvani Goolsarran
Nafcillin-induced acute liver injury is a rare and potentially fatal complication that has been known since the 1960s but inadequately studied. At this time, the only proven treatment is early discontinuation of the drug. Because of the high prevalence of nafcillin class antibiotic use in the United States, it is important for clinicians to have a high clinical suspicion for this diagnosis. We present a case of liver failure attributable to nafcillin use in a 68-year-old male with a history methicillin-sensitive Staphylococcus and L3/L4 osteomyelitis...
September 2017: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/29031934/-we-don-t-have-the-infrastructure-to-support-them-at-home-how-health-system-inadequacies-impact-on-long-term-care-admissions-of-people-with-dementia
#8
Nora-Ann Donnelly, Niamh Humphries, Anne Hickey, Frank Doyle
OBJECTIVES: The influence of healthcare system factors on long-term care admissions has received relatively little attention. We address this by examining how inadequacies in the healthcare system impact on long-term care admissions of people with dementia. This is done in the context of the Irish healthcare system. METHODS: Thirty-eight qualitative in-depth interviews with healthcare professionals and family carers were conducted. Interviews focused on participants' perceptions of the main factors which influence admission to long-term care...
October 6, 2017: Health Policy
https://www.readbyqxmd.com/read/29031431/implementing-an-antibiotic-stewardship-program-at-a-long-term-acute-care-hospital-in-detroit-michigan
#9
Ammara Mushtaq, Reda A Awali, Suganya Chandramohan, Amar Krishna, Caitlin Biedron, Olufemi Jegede, Teena Chopra
BACKGROUND: The objective of the study was to assess health care providers' (HCPs) knowledge and attitude toward antimicrobial resistance (AMR) and implement an antimicrobial stewardship program (ASP) in a long-term acute care hospital (LTACH). METHODS: A questionnaire on antibiotic use and resistance was administered to HCP in an LTACH in Detroit, Michigan, between August 2011 and October 2011. Concurrently, a retrospective review of common antibiotic prescription practices and costs was conducted...
October 11, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29031347/rehabilitation-needs-of-the-elder-with-traumatic-brain-injury
#10
REVIEW
Manuel F Mas, Amy Mathews, Ekua Gilbert-Baffoe
The incidence of traumatic brain injury (TBI) in older adults is increasing. As the expected life expectancy increases, there is a heightened need for comprehensive rehabilitation for this population. Elderly patients with TBI benefit from rehabilitation interventions at all stages of injury and can achieve functional gains during acute inpatient rehabilitation. Clinicians should be vigilant of unique characteristics of this population during inpatient rehabilitation, including vulnerability to polypharmacy, posttraumatic hydrocephalus, neuropsychiatric sequelae, sleep disturbances, and sensory deficits...
November 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/29029706/pulmonary-embolism-in-2017-how-we-got-here-and-where-are-we-going
#11
Geno J Merli
In the 1970s, both the Urokinase Pulmonary Embolism and Urokinase-Streptokinase Pulmonary Embolism trials began the quest to develop thrombolytic therapy for the treatment of acute massive and submassive pulmonary embolism (PE). The goals of these studies were the immediate reduction in clot burden, restoration of hemodynamic stability, and improved survival. Major bleeding became the major barrier for clinicians to employ these therapies. From 1980s to the present time, a number of studies using recombinant tissue-type plasminogen activator for achieving these same above outcomes were completed but major bleeding continued to remain an adoption barrier...
September 2017: Techniques in Vascular and Interventional Radiology
https://www.readbyqxmd.com/read/29029541/cancer-and-the-kidney-dangereoux-liasons-or-price-paid-for-the-progress-in-medicine
#12
REVIEW
Jolanta Małyszko, Leszek Kozlowski, Klaudia Kozłowska, Maciej Małyszko, Jacek Małyszko
A long time ago, the links between renal disease and malignancy were observed, however, quite recently, their importance was recognized and 'new' subspecialty in nephrology, namely 'onconephrology' was established. In the XXI century, patients with malignancy make up the most growing number of the subjects seen for nephrology consult and/or critical care nephrology services. A plethora of renal problems may be found in patients with malignancy. They may influence not only their short-term outcomes but also the adequate therapy of the underlying oncological problem...
September 12, 2017: Oncotarget
https://www.readbyqxmd.com/read/29027072/outcomes-of-acute-kidney-injury-in-a-nephrology-ward
#13
Ana R Fernandes, Márcio S R Viegas, Elsa Q Soares, Sofia S Coelho, Patricia Valério, José C Barreto, José M Vinhas
Acute kidney injury (AKI) is a global problem which predicts immediate and long-term adverse outcomes. We evaluated the AKI progression to end-stage renal disease, as well as the mortality associated with AKI and the in-hospital readmission rate because of a cardiovascular event in AKI patients admitted in a nephrology ward. A 5-year retrospective study was set in a nephrology department, with a follow-up period of up to 8 years. In a total of 191 patients, mean age was 73.83 ± 12.49 years, and 137 (71...
October 11, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/29021114/a-police-led-addiction-treatment-referral-program-in-gloucester-ma-implementation-and-participants-experiences
#14
Davida M Schiff, Mari-Lynn Drainoni, Zoe M Weinstein, Lisa Chan, Megan Bair-Merritt, David Rosenbloom
BACKGROUND: The increasing rates of opioid use disorder and resulting overdose deaths are a public health emergency, yet only a fraction of individuals in need receive treatment. OBJECTIVE: To describe the implementation of and participants' experiences with a novel police-led addiction treatment referral program. METHODS: Follow-up telephone calls to participants in the Gloucester Police Department's Angel Program from June 2015-May 2016...
November 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/29019269/the-burden-of-severe-hypoglycemia-in-type-1-diabetes
#15
Jieruo Liu, Rosa Wang, Michael L Ganz, Yurek Paprocki, Doron Schneider, James Weatherall
AIMS: Approximately 1.25 million people in the United States have type 1 diabetes mellitus (T1DM), a chronic metabolic disease that develops from the body's inability to produce insulin, and requires life-long insulin therapy. Poor insulin adherence may cause severe hypoglycemia (SHO), leading to hospitalization and long-term complications; these, in turn, drive up costs of SHO and T1DM overall. This study's objective was to estimate the prevalence and costs of SHO-related hospitalizations and their additional longer-term impacts on patients with T1DM using basal-bolus insulin...
October 11, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29017368/the-burden-of-severe-hypoglycemia-in-type-2-diabetes
#16
Jieruo Liu, Rosa Wang, Michael L Ganz, Yurek Paprocki, Doron Schneider, James Weatherall
AIMS: More than 29 million people in the United States have type 2 diabetes mellitus (T2DM), a chronic metabolic disorder characterised by a progressive deterioration of glucose control, which eventually requires insulin. Abnormally low levels of blood glucose, a feared side effect of insulin treatment, may cause severe hypoglycemia (SHO), leading to emergency department (ED) admission, hospitalization, and long-term complications; these, in turn, drive up the costs of T2DM. This study's objective was to estimate the prevalence and costs of SHO-related hospitalizations and their additional longer-term impact on patients with T2DM using insulin...
October 11, 2017: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/28994446/colonization-of-residents-and-staff-of-an-italian-long-term-care-facility-and-an-adjacent-acute-care-hospital-geriatric-unit-by-multidrug-resistant-bacteria
#17
Albert March, Richard Aschbacher, Ferisa Sleghel, Gertrud Soelva, Malgorzata Kaczor, Roberta Migliavacca, Aurora Piazza, Vittoria Mattioni Marchetti, Laura Pagani, Katia Scalzo, Valentina Pasquetto, Elisabetta Pagani
In 2016, we undertook a point prevalence screening study for Enterobacteriaceae with extended-spectrum β-lactamases (ESBLs), high-level AmpC cephalosporinases and carbapenemases, and also methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin resistant enterococci (VRE) in a long-term care facility (LTCF) and the associated acute care hospital geriatric unit in Bolzano, Northern Italy. Urine samples and rectal, inguinal, oropharyngeal and nasal swabs were plated on selective agars. Demographic data were collected...
October 10, 2017: New Microbiologica
https://www.readbyqxmd.com/read/28991920/health-related-impact-on-quality-of-life-and-coping-strategies-for-chikungunya-a-qualitative-study-in-cura%C3%A3-ao
#18
Jelte Elsinga, Martin P Grobusch, Adriana Tami, Izzy Gerstenbluth, Ajay Bailey
INTRODUCTION: Chikungunya is an emerging public health problem in tropical and subtropical regions, due to ongoing transmission and its incapacitating acute disease phase, and chronic sequelae. The disease is responsible for a major impact on Health Related Quality of Life (HRQoL), which may last several years. To our knowledge, this study is the first qualitative examination of HRQoL and coping strategies of chikungunya-infected individuals. METHODS: Qualitative research methods consisted of 20 in-depth interviews and seven Focus Group Discussions (FGDs), n = 50...
October 9, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28991602/nurses-experiences-of-end-of-life-care-in-long-term-care-hospitals-in-japan-balancing-improving-the-quality-of-life-and-sustaining-the-lives-of-patients-dying-at-hospitals
#19
Ryo Odachi, Tomoko Tamaki, Mikiko Ito, Taketoshi Okita, Yuri Kitamura, Tomotaka Sobue
PURPOSE: In Japan, about 80% of deaths occur in hospitals, especially long-term care beds. The purpose of this study was to clarify the nursing practices used for such older patients at the end-of-life stage in long-termcare wards via the modified grounded theory approach (M-GTA). METHODS: Data were obtained through semi-structured interviews of nineteen nurses working in cooperating long-term care wards, acute care wards, or hospice services (to allow for constant comparison between these types of wards) in western Japan in 2014...
September 2017: Asian Nursing Research
https://www.readbyqxmd.com/read/28991368/predicting-discharge-to-institutional-long-term-care-after-stroke-a-systematic-review-and-metaanalysis
#20
Jennifer K Burton, Eilidh E C Ferguson, Amanda J Barugh, Katherine E Walesby, Alasdair M J MacLullich, Susan D Shenkin, Terry J Quinn
BACKGROUND/OBJECTIVES: Stroke is a leading cause of disability worldwide, and a significant proportion of stroke survivors require long-term institutional care. Understanding who cannot be discharged home is important for health and social care planning. Our aim was to establish predictive factors for discharge to institutional care after hospitalization for stroke. DESIGN: We registered and conducted a systematic review and meta-analysis (PROSPERO: CRD42015023497) of observational studies...
October 9, 2017: Journal of the American Geriatrics Society
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