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https://www.readbyqxmd.com/read/29927640/does-anterior-cruciate-ligament-reconstruction-improve-functional-and-radiographic-outcomes-over-nonoperative-management-5-years-after-injury
#1
Elizabeth Wellsandt, Matthew J Failla, Michael J Axe, Lynn Snyder-Mackler
BACKGROUND: Current practice patterns for the management of anterior cruciate ligament (ACL) injury favor surgical reconstruction. However, long-term outcomes may not differ between patients completing operative and nonoperative treatment of ACL injury. Differences in outcomes between operative and nonoperative treatment of patients in the United States is largely unknown, as are outcomes in long-term strength and performance measures. PURPOSE: To determine if differences exist in 5-year functional and radiographic outcomes between patients completing operative and nonoperative treatment of ACL injury when both groups complete a progressive criterion-based rehabilitation protocol...
June 1, 2018: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/29921716/acute-complement-inhibition-potentiates-neurorehabilitation-and-enhances-tpa-mediated-neuroprotection
#2
Ali Alawieh, Meredith Andersen, DeAnna L Adkins, Stephen Tomlinson
Since complement activation in the subacute or chronic phase after stroke was recently shown to stimulate neural plasticity, we investigated how complement activation and complement inhibition in the acute phase after murine stroke interacts with subsequent rehabilitation therapy to modulate neuroinflammation and neural remodeling. We additionally investigated how complement and complement inhibition interacts with tissue plasminogen activator (tPA), the other standard of care therapy for stroke, and an FDA preclinical requirement for translation of an experimental stroke therapy...
June 19, 2018: Journal of Neuroscience: the Official Journal of the Society for Neuroscience
https://www.readbyqxmd.com/read/29921399/prediction-of-length-of-hospital-stay-and-mortality-in-patients-with-delirium-a-prospective-cohort-analysis-of-200-icu-patients
#3
J Tian, X Chen, D Liu
Delirium develops in most critically ill Intensive Care Unit (ICU) patients and is associated with longer hospital stay, increased rate of mortality and increased cost of healthcare. The purpose of this study was to evaluate the incidence of delirium in non-ventilated ICU patients and demonstrate its clinical association with the hospital/ ICU length of stay and in-patient mortality. A total of 200 ICU patients (aged 18 years or over) who were admitted to the ICU with specific primary diagnoses were selected for the study and followed up until either hospital discharge or death...
May 2018: Journal of Biological Regulators and Homeostatic Agents
https://www.readbyqxmd.com/read/29917071/individualization-and-the-health-care-mosaic-in-assisted-living
#4
Candace L Kemp, Mary M Ball, Molly M Perkins
Background and Objectives: Assisted living (AL) is a popular residential long-term care option for frail older adults in the United States. Most residents have multiple comorbidities and considerable health care needs, but little is known about their health care arrangements, particularly over time. Our goal is to understand how health care is managed and experienced in AL by residents and their care network members. Research Design and Methods: This grounded theory analysis focuses on the delivery of health care in AL...
June 15, 2018: Gerontologist
https://www.readbyqxmd.com/read/29915333/impact-of-bronchiectasis-on-outcomes-of-hospitalized-patients-with-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-a-propensity-matched-analysis
#5
Ernesto Crisafulli, Mónica Guerrero, Antonella Ielpo, Adrian Ceccato, Arturo Huerta, Albert Gabarrús, Néstor Soler, Alfredo Chetta, Antoni Torres
The coexistence of both Chronic Obstructive Pulmonary Disease (COPD) and bronchiectasis (BE) define an emerging phenotype with a worse prognosis; however, data about these patients do not consider baseline characteristics as confounders. We evaluate the impact of BE on outcomes of hospitalized patients with acute exacerbation of COPD (AECOPD). We prospectively considered AECOPD patients, analysed using a propensity score matching (PSM) method. The outcomes included length of hospital stay, use of non-invasive and invasive mechanical ventilation, intensive care unit admission, and mortality up to 3-years...
June 18, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29909444/gender-disparities-in-presentation-management-and-outcomes-of-acute-myocardial-infarction
#6
REVIEW
Matthew Liakos, Puja B Parikh
PURPOSE OF REVIEW: This review provides updates in gender disparities in the symptom profile, risk factors, quality and timeliness of guideline-based medical care, and clinical outcomes, including mortality, bleeding, and vascular complications, in patients with acute myocardial infarction (AMI). RECENT FINDINGS: While AMI continues to be a leading cause of mortality in both men and women, significant gender differences exist in presentation, management, and outcomes...
June 16, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29909373/what-insights-do-patients-and-caregivers-have-on-acute-kidney-injury-and-posthospitalisation-care-a-single-centre-qualitative-study-from-toronto-canada
#7
Samuel A Silver, Marianne Saragosa, Neill K Adhikari, Chaim M Bell, Ziv Harel, Andrea Harvey, Abhijat Kitchlu, Javier A Neyra, Ron Wald, Lianne Jeffs
OBJECTIVES: Hospitalisation with acute kidney injury (AKI) is associated with short-term and long-term adverse events, but patient and caregiver experiences with AKI are not well described. We sought to better understand patient and caregiver perspectives after a hospitalisation with AKI to inform discharge strategies that may improve outcomes for this high-risk population. DESIGN: Qualitative study with semistructured interviews. SETTING: Tertiary care hospital in Toronto, Ontario, Canada...
June 15, 2018: BMJ Open
https://www.readbyqxmd.com/read/29907898/inpatient-glycemic-management-of-non-cardiac-cvd-focus-on-stroke-and-pvd
#8
REVIEW
Estelle Everett, Nestoras Mathioudakis
PURPOSE OF REVIEW: Hyperglycemia occurs frequently in hospitalized patients with stroke and peripheral vascular disease (PVD). Guidelines for inpatient glycemic management are not well established for this patient population. We will review the clinical impact of hyperglycemia in this acute setting and review the evidence for glycemic control. RECENT FINDINGS: Hyperglycemia in acute stroke is associated with poor short and long-term outcomes, and perioperative hyperglycemia in those undergoing revascularization for PVD is linked to increased post-surgical complications...
June 16, 2018: Current Diabetes Reports
https://www.readbyqxmd.com/read/29905578/translational-models-of-infection-prevention-and-control-lessons-from-studying-high-risk-aging-populations
#9
Lona Mody
PURPOSE OF REVIEW: The present review describes our research experiences and efforts in advancing the field of infection prevention and control in nursing facilities including postacute and long-term care settings. RECENT FINDINGS: There are over two million infections in postacute and long-term care settings each year in the United States and $4 billion in associated costs. To define a target group most amenable to infection prevention and control interventions, we sought to quantify the relation between indwelling device use and microbial colonization in nursing facility patients...
June 13, 2018: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/29904810/colchicine-in-pericardial-disease-from-the-underlying-biology-and-clinical-benefits-to-the-drug-drug-interactions-in-cardiovascular-medicine
#10
REVIEW
Aldo L Schenone, Venu Menon
PURPOSE OF REVIEW: This is an in-depth review on the mechanism of action, clinical utility, and drug-drug interactions of colchicine in the management of pericardial disease. RECENT FINDINGS: Recent evidence about therapeutic targets on pericarditis has demonstrated that NALP3 inflammasome blockade is the cornerstone in the clinical benefits of colchicine. Such benefits extend from acute and recurrent pericarditis to transient constriction and post-pericardiotomy syndrome...
June 14, 2018: Current Cardiology Reports
https://www.readbyqxmd.com/read/29901592/the-heterogeneous-management-of-pediatric-ankle-traumas-a-retrospective-descriptive-study
#11
Philippe Voizard, James Moore, Stéphane Leduc, Marie-Lyne Nault
Frequent misdiagnosis of pediatric ankle traumas leads to inappropriate management, which may result in residual pain, instability, slower return to physical activity, and long-term degenerative changes. The purpose of this study was to evaluate the consistency of diagnosis, management, and the treatment of acute lateral pediatric ankle trauma in a tertiary care pediatric hospital. The hypothesis was that the initial diagnosis is often incorrect, and the treatment varies considerably amongst orthopedic surgeons...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29901462/changing-paradigms-in-metabolic-support-and-nutrition-therapy-during-critical-illness
#12
Arthur R H van Zanten
PURPOSE OF REVIEW: To summarize the most recent advances in acute metabolic care and critical care nutrition. RECENT FINDINGS: Recent research has demonstrated unknown consequences of high protein and amino acid administration in the early phase of ICU stay associated with dysregulated glucagon release leading to hepatic amino acid breakdown and suggested adverse effects on autophagy and long-term outcome. Progress has been made to measure body composition in the ICU...
June 8, 2018: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29899889/acute-myeloid-leukemia-chimeric-antigen-receptor-t-cell-immunotherapy-how-far-up-the-road-have-we-traveled
#13
REVIEW
Sarah K Tasian
Chemotherapy resistance and relapse remain significant sources of mortality for children and adults with acute myeloid leukemia (AML). Further intensification of conventional cytotoxic chemotherapy is likely not feasible due to the severity of acute and long-term side effects upon normal tissues commonly induced by these drugs. Successful development and implementation of new precision medicine treatment approaches for patients with AML, which may improve leukemia remission and diminish toxicity, is thus a major priority...
June 2018: Therapeutic Advances in Hematology
https://www.readbyqxmd.com/read/29898463/efficacy-and-effectiveness-of-lithium-in-the-long-term-treatment-of-bipolar-disorders-an-update-2018
#14
Emanuel Severus, Michael Bauer, John Geddes
For more than 40 years, lithium has been the gold standard in the long-term treatment of bipolar disorders. In the course of the last 15 years, other drugs have been approved in this indication and are widely used in clinical practice at the expense of lithium. New research from the last few years, however, indicates that lithium is still the first-line treatment in this indication. Against this background and lithium's proven acute antimanic efficacy, we should perhaps be using lithium more regularly (in combination with an atypical antipsychotic, if necessary) right from the start for the acute treatment of a manic episode and, once remission has been achieved and euthymia maintained during continuation treatment, to regularly taper off the atypical antipsychotic, if possible, and continue with lithium as monotherapy for prophylactic treatment...
June 13, 2018: Pharmacopsychiatry
https://www.readbyqxmd.com/read/29895662/acute-lymphoblastic-leukemia-in-adolescent-and-young-adults-treat-as-adults-or-as-children
#15
Nicolas Boissel, André Baruchel
Adolescent and young adult (AYA) patients with acute lymphoblastic leukemia (ALL) are recognized as a unique population with specific characteristics and needs. In adolescents aged 15-20 years old, the use of full pediatric protocols is supported by many comparative studies of pediatric and adult cooperative groups. In young adults, growing evidence suggests that pediatric-inspired or even fully pediatric approaches may also dramatically improve outcomes, leading to long-term survival rates of almost 70%, despite diminishing indications of hematopoietic stem cell transplantation...
June 12, 2018: Blood
https://www.readbyqxmd.com/read/29890862/improving-diaper-performance-for-extremely-low-birth-weight-infants
#16
Veronica Sanchez, Michelle Maladen-Percy, Jennifer Gustin, Amy Tally, Roger Gibb, Julie Ogle, Dianna C Kenneally, Andrew N Carr
BACKGROUND: Extremely low-birth-weight (ELBW) infants face significant diapering challenges compared with their full-term peers, due to immature musculature, nervous system, and skin development. Advances in medical care has increased an ELBW infant's rate of survival, which creates a growing need for diapers to better serve these infants. Aim of research. The objective of this study was to identify and confirm the requirements for optimal diaper performance from the neonatal intensive care unit nurses' perspective, as well as to assess in-hospital performance to determine if new features improved key developmental care parameters...
June 1, 2018: Clinical Pediatrics
https://www.readbyqxmd.com/read/29890540/rehabilitation-after-clipping-of-cerebral-aneurysms-without-acute-subarachnoid-hemorrhage-outcome-analysis-of-100-consecutive-cases
#17
Andreas Jödicke, Karsten Bauer, Andrea Hajdukova
BACKGROUND:  Discharge to rehabilitation is reported in large studies as one important outcome parameter based on hospital codes. Because neurologic outcome scores (e.g., the modified Rankin Scale [mRS]) are missing in International Classification of Diseases (ICD) databases, rehabilitation indirectly serves as a kind of surrogate parameter for overall outcome. Reported fractions of patients with rehabilitation, however, largely differ between studies and seem high for patients with aneurysm clipping...
June 11, 2018: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/29889166/not-every-fulminant-lymphocytic-myocarditis-fully-recovers
#18
Giacomo Veronese, Manlio Cipriani, Duccio Petrella, Patrizia Pedrotti, Cristina Giannattasio, Andrea Garascia, Fabrizio Oliva, Karin Klingel, Maria Frigerio, Enrico Ammirati
: Fulminant myocarditis is a distinct entity within the acute forms of myocarditis characterized by a rapidly progressive clinical course. Lymphocytic forms have been historically reported to generally resolve spontaneously with early appropriate aggressive supportive care alone. We describe the case of a 28-year-old man with lymphocytic fulminant myocarditis presenting with out-of-hospital cardiac arrest, treated with veno-arterial extracorporeal membrane oxygenation, progressed to end stage cardiac failure requiring heart transplantation...
June 7, 2018: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/29888800/expanding-opportunities-in-the-post-acute-long-term-care-pa-ltc-setting-bringing-medication-safety-to-the-next-level
#19
Nicole J Brandt, Chad Worz, Sharon F Clackum
Skilled nursing facilities and nursing homes are a care setting that offers increasing opportunities for pharmacists to be leaders when addressing the new updated Centers for Medicare and Medicaid Services requirements coupled with the enhanced quality measures reporting. Additionally, the complexity of the medication-related needs and comorbidities of the patients served in long-term care facilities promotes pharmacists practicing to the top of their license. Medication stewardship needs to be an interdisciplinary team activity led by the pharmacist...
June 11, 2018: Pharmacotherapy
https://www.readbyqxmd.com/read/29887301/treatment-of-post-traumatic-psychiatric-disorders-a-continuum-of-immediate-post-immediate-and-follow-up-care-mediated-by-specific-psychotherapeutic-principles-clinical-experience-in-french-speaking-countries
#20
Yann Auxéméry
BACKGROUND: People who witness a horrific event are at risk of suffering from acute psychological disorders, potentially leading to chronic post-traumatic symptoms and severe medico-psycho-social complications. Traumatised individuals suffer from psychological damage that is initially indescribable: they are often unable to ask for care in the immediate aftermath of an event. Afterwards, traumatic events and their post-traumatic consequences are still often hidden or minimised by patients for reasons linked to the disorder itself (inexpressibility, shame, depressive thoughts, fear of stigmatisation, etc...
June 7, 2018: L'Encéphale
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