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https://www.readbyqxmd.com/read/27923248/timing-of-multiorgan-dysfunction-among-hospitalized-infants-with-fatal-fulminant-sepsis
#1
James L Wynn, Matthew S Kelly, Daniel K Benjamin, Reese H Clark, Rachel Greenberg, Daniel K Benjamin, P Brian Smith
Objective Identify the progression of specific signs of multiorgan dysfunction among infants with fatal sepsis. Study Design Cohort study of 679 infants who died within 3 days of the start of a late-onset sepsis (LOS) episode in neonatal intensive care units from 1997 to 2012. We extracted clinical and laboratory data on the day of death (day 0) and the preceding 5 days (days -5 to -1). Results Median (25th percentile-75th percentile) gestational age was 25 (24-28) weeks. Compared with day -1, day 0 was characterized by an increased requirement for mechanical ventilation and higher mean fraction of inspired oxygen...
December 6, 2016: American Journal of Perinatology
https://www.readbyqxmd.com/read/27922454/a-clinician-s-guide-to-privacy-and-communication-in-the-icu
#2
Leslie Francis, Micah A Vorwaller, Hanan Aboumatar, Dominick L Frosch, John Halamka, Ronen Rozenblum, Eileen Rubin, Barbara Sarnoff Lee, Jeremy Sugarman, Kathleen Turner, Samuel M Brown
OBJECTIVE: To review the legal issues concerning family members' access to information when patients are in the ICU. DATA SOURCES: U.S. Code, U.S. Code of Federal Regulations, and state legislative codes. DATA EXTRACTION: Relevant legal statutes and regulations were identified and reviewed by the two attorney authors (L. F., M. A. V.). STUDY SELECTION: Not applicable. DATA SYNTHESIS: Review by all coauthors...
December 2, 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27922342/treatment-seeking-and-out-of-pocket-expenditure-on-childhood-illness-in-a-migrant-tribal-community-in-bhubaneswar-odisha-state-india
#3
Suchismita Mishra, Yadlapalli S Kusuma, Bontha V Babu
BACKGROUND: In India, migrant status, tribal affiliation and poverty render tribal migrants more vulnerable than any other group which leads to high treatment costs and the risk of low access to health care. OBJECTIVE: To examine treatment-seeking behaviour and out-of-pocket (OOP) expenditure on the treatment of childhood illnesses, with a focus on gender in a migrant tribal community in Bhubaneswar, eastern India. METHODS: A total of 175 households with a child aged 0-14 years and who had migrated within the last 12 years were selected from tribal-dominated slums...
December 6, 2016: Paediatrics and International Child Health
https://www.readbyqxmd.com/read/27920578/recording-of-hospitalizations-for-acute-exacerbations-of-copd-in-uk-electronic-health-care-records
#4
Kieran J Rothnie, Hana Müllerová, Sara L Thomas, Joht S Chandan, Liam Smeeth, John R Hurst, Kourtney Davis, Jennifer K Quint
BACKGROUND: Accurate identification of hospitalizations for acute exacerbations of chronic obstructive pulmonary disease (AECOPD) within electronic health care records is important for research, public health, and to inform health care utilization and service provision. We aimed to develop a strategy to identify hospitalizations for AECOPD in secondary care data and to investigate the validity of strategies to identify hospitalizations for AECOPD in primary care data. METHODS: We identified patients with chronic obstructive pulmonary disease (COPD) in the Clinical Practice Research Datalink (CPRD) with linked Hospital Episodes Statistics (HES) data...
2016: Clinical Epidemiology
https://www.readbyqxmd.com/read/27920549/management-of-hypoglycemia-in-nondiabetic-palliative-care-patients-a-prognosis-based-approach
#5
REVIEW
Victor C Kok, Ping-Hsueh Lee
Hypoglycemia due to underlying terminal illness in nondiabetic end-of-life patients receiving palliative care has not been fully studied. For example, we do not have adequate information on the frequency of spontaneous hypoglycemia in patients as occurs during the different stages of palliative care. Depending on the case-mix nature of the palliative care ward, at least 2% of palliative care patients may develop hypoglycemia near the end of life when the remaining life expectancy counts down in days. As many as 25%-60% of these patients will neither have autonomic response nor have neuroglycopenic symptoms during a hypoglycemic episode...
2016: Palliative Care
https://www.readbyqxmd.com/read/27920512/the-burden-of-chronic-obstructive-pulmonary-disease-associated-with-maintenance-monotherapy-in-the-uk
#6
Susan C Edwards, Sian E Fairbrother, Anna Scowcroft, Gavin Chiu, Andrew Ternouth, Brian J Lipworth
BACKGROUND: This study characterized a cohort of chronic obstructive pulmonary disease (COPD) patients on maintenance bronchodilator monotherapy for ≥6 months to establish their disease burden, measured by health care utilization. METHODS: Data were extracted from the UK Clinical Practice Research Datalink and linked to Hospital Episode Statistics. The monotherapy period spanned the first prescription of a long-acting β2-adrenergic agonist or a long-acting muscarinic antagonist until the end of the study (December 31, 2013) or until step up to dual/triple therapy, for example, addition of another long-acting bronchodilator, an inhaled corticosteroid, or both...
2016: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/27919580/variation-in-diagnoses-for-hip-arthroplasty-among-new-york-state-hospitals-implications-for-the-comprehensive-care-for-joint-replacement-model
#7
John A Buza, Jeffrey M Jancuska, James D Slover, Richard Iorio, Joseph A Bosco
BACKGROUND: The Comprehensive Care for Joint Replacement model is designed to minimize costs and improve quality for Medicare patients undergoing joint arthroplasty. The cost of hip arthroplasty (HA) episode varies depending on the preoperative diagnosis and is greater for fracture than for osteoarthritis. Hospitals that perform a higher percentage of HA for OA may therefore have an advantage in the Comprehensive Care for Joint Replacement model. The purposes of this study are to (1) determine the variability in underlying diagnosis for HA in New York State hospitals, and (2) determine hospital characteristics, such as volume, associated with this...
November 15, 2016: Journal of Arthroplasty
https://www.readbyqxmd.com/read/27919514/the-psychological-impact-of-symptoms-related-to-esophagogastric-cancer-resection-presenting-in-primary-care-a-national-linked-database-study
#8
G Bouras, S R Markar, E M Burns, J R Huddy, A Bottle, T Athanasiou, A Darzi, G B Hanna
BACKGROUND: The objective was to evaluate incidence, risk factors and impact of postoperative symptoms following esophagogastric cancer resection in primary care. METHODS: Patients undergoing esophagogastrectomy for cancer from 1998 to 2010 with linked records in Clinical Practice Research Datalink, Hospital Episodes Statistics and Office of National Statistics databases were studied. The recording of codes for reflux, dysphagia, dyspepsia, nausea, vomiting, dumping, diarrhea, steatorrhea, appetite loss, weight loss, pain and fatigue were identified up to 12 months postoperatively...
November 9, 2016: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/27919307/patterns-and-correlates-of-major-depression-in-chinese-adults-a-cross-sectional-study-of-0-5-million-men-and-women
#9
Y Chen, D Bennett, R Clarke, Y Guo, C Yu, Z Bian, L Ma, Y Huang, Q Sun, N Zhang, X Zheng, J Chen, R Peto, K S Kendler, L Li, Z Chen
BACKGROUND: Worldwide 350 million people suffer from major depression, with the majority of cases occurring in low- and middle-income countries. We examined the patterns, correlates and care-seeking behaviour of adults suffering from major depressive episode (MDE) in China. METHOD: A nationwide study recruited 512 891 adults aged 30-79 years from 10 provinces across China during 2004-2008. The 12-month prevalence of MDE was assessed by the Modified Composite International Diagnostic Interview-short form...
December 6, 2016: Psychological Medicine
https://www.readbyqxmd.com/read/27917737/a-pediatric-approach-to-ventilator-associated-events-surveillance
#10
Noelle M Cocoros, Gregory P Priebe, Latania K Logan, Susan Coffin, Gitte Larsen, Philip Toltzis, Thomas J Sandora, Marvin Harper, Julia S Sammons, James E Gray, Donald Goldmann, Kelly Horan, Michael Burton, Paul A Checchia, Matthew Lakoma, Shannon Sims, Michael Klompas, Grace M Lee
OBJECTIVE Adult ventilator-associated event (VAE) definitions include ventilator-associated conditions (VAC) and subcategories for infection-related ventilator-associated complications (IVAC) and possible ventilator-associated pneumonia (PVAP). We explored these definitions for children. DESIGN Retrospective cohort SETTING Pediatric, cardiac, or neonatal intensive care units (ICUs) in 6 US hospitals PATIENTS Patients ≤18 years old ventilated for ≥1 day METHODS We identified patients with pediatric VAC based on previously proposed criteria...
December 5, 2016: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/27916584/immunological-and-infectious-risk-factors-for-lung-cancer-in-us-veterans-with-hiv-a-longitudinal-cohort-study
#11
Keith Sigel, Juan Wisnivesky, Kristina Crothers, Kirsha Gordon, Sheldon T Brown, David Rimland, Maria C Rodriguez-Barradas, Cynthia Gibert, Matthew Bidwell Goetz, Roger Bedimo, Lesley S Park, Robert Dubrow
BACKGROUND: HIV infection is independently associated with risk of lung cancer, but few data exist for the relation between longitudinal measurements of immune function and lung-cancer risk in people living with HIV. METHODS: We followed up participants with HIV from the Veterans Aging Cohort Study for a minimum of 3 years between Jan 1, 1998, and Dec 31, 2012, and used cancer registry data to identify incident cases of lung cancer. The index date for each patient was the later of the date HIV care began or Jan 1, 1998...
December 1, 2016: Lancet HIV
https://www.readbyqxmd.com/read/27916176/functional-assessment-and-transplantation-of-the-donor-heart-after-circulatory-death
#12
Simon J Messer, Richard G Axell, Simon Colah, Paul A White, Marian Ryan, Aravinda A Page, Barbora Parizkova, Kamen Valchanov, Christopher W White, Darren H Freed, Euan Ashley, John Dunning, Martin Goddard, Jayan Parameshwar, Christopher J Watson, Thomas Krieg, Ayyaz Ali, Steven Tsui, Stephen R Large
BACKGROUND: After a severe shortage of brain-dead donors, the demand for heart transplantation has never been greater. In an attempt to increase organ supply, abdominal and lung transplant programs have turned to the donation after circulatory-determined death (DCD) donor. However, because heart function cannot be assessed after circulatory death, DCD heart transplantation was deemed high risk and never adopted routinely. We report a novel method of functional assessment of the DCD heart resulting in a successful clinical program...
December 2016: Journal of Heart and Lung Transplantation
https://www.readbyqxmd.com/read/27915351/the-role-of-nephrologist-in-the-intensive-care-unit
#13
Zoltán H Endre
Participation by nephrologists is needed in most intensive care units, even when such units are 'closed'. This participation should assist with diagnosis and management of intrinsic and complex renal diseases such as vasculitis, complex metabolic and electrolyte disorders including hyponatremia, and acute kidney injury (AKI) with and without underlying chronic kidney disease (CKD). Early nephrologist involvement will also facilitate transition to continuing care and follow-up after an episode of AKI, but may also assist in avoiding dialysis where treatment is futile...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27915229/increased-orthogeriatrician-involvement-in-hip-fracture-care-and-its-impact-on-mortality-in-england
#14
Jenny Neuburger, Colin Currie, Robert Wakeman, Antony Johansen, Carmen Tsang, Fay Plant, Helen Wilson, David A Cromwell, Jan van der Meulen, Bianca De Stavola
OBJECTIVES: to describe the increase in orthogeriatrician involvement in hip fracture care in England and its association with improvements in time to surgery and mortality. STUDY DESIGN: analysis of Hospital Episode Statistics for 196,401 patients presenting with hip fracture to 150 hospitals in England between 1 April 2010 and 28 February 2014, combined with data on orthogeriatrician hours from a national organisational survey. METHODS: we examined changes in the average number of hours worked by orthogeriatricians in orthopaedic departments per patient with hip fracture, and their potential effect on mortality within 30 days of presentation...
December 2, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27914729/operative-team-communication-during-simulated-emergencies-too-busy-to-respond
#15
W Austin Davis, Seth Jones, Adrianna M Crowell-Kuhnberg, Dara O'Keeffe, Kelly M Boyle, Suzanne B Klainer, Douglas S Smink, Steven Yule
BACKGROUND: Ineffective communication among members of a multidisciplinary team is associated with operative error and failure to rescue. We sought to measure operative team communication in a simulated emergency using an established communication framework called "closed loop communication." We hypothesized that communication directed at a specific recipient would be more likely to elicit a check back or closed loop response and that this relationship would vary with changes in patients' clinical status...
November 30, 2016: Surgery
https://www.readbyqxmd.com/read/27914684/sickle-cell-disease-in-the-older-adult
#16
REVIEW
Mya S Thein, Norris E Igbineweka, Swee Lay Thein
Sickle cell disease (SCD) is an inherited haemoglobin disorder, associated with recurrent painful episodes, ongoing haemolytic anaemia and progressive multi-organ damage. Until the early 1990s, survival beyond the fourth decade for a patient with SCD was considered unusual and prompted case reports. Nowadays, in countries with developed health care systems, more than 90 percent of newborns with SCD survive into adulthood. Nevertheless, their life expectancy is still shortened by more than two decades compared to the general population...
November 30, 2016: Pathology
https://www.readbyqxmd.com/read/27914484/comparing-non-occupational-post-exposure-prophylaxis-drug-regimens-for-hiv-insights-from-a-linked-hiv-surveillance-system
#17
Anna B Pierce, Carol El-Hayek, Damien McCarthy, Jude Armishaw, Kerrie Watson, Anna Wilkinson, Brian Price, Edwina J Wright, Jennifer F Hoy, Mark A Stoové
Background: International non-occupational post-exposure prophylaxis (NPEP) guidelines recommend routine use of three drug NPEP regimens, despite absence of evidence for greater prevention efficacy compared with two drug regimens. This study examines the potential for excess HIV seroconversions among high-risk men who have sex with men (MSM) reporting receptive anal intercourse with a source of unknown HIV serostatus (RAIU) following a two-drug versus a three-drug NPEP regimen. Methods: Data for MSM in the Victorian NPEP service database between 10 August 2005 and 31 December 2012 were linked with all Victorian HIV notifications up to 31 December 2013...
December 5, 2016: Sexual Health
https://www.readbyqxmd.com/read/27914153/-pulmonary-embolism-in-portugal-epidemiology-and-in-hospital-mortality
#18
Miguel Gouveia, Luís Pinheiro, João Costa, Margarida Borges
INTRODUCTION: In Portugal, the epidemiology of acute pulmonary embolism is poorly understood. In this study, we sought to characterize the pulmonary embolism from the hospital data and evaluate its in-hospital mortality and respective prognostic factors. MATERIAL AND METHODS: The study used diagnostic related groups data from National Health System hospitals from 2003 to 2013 and National Statistics Institute population data to establish the evolution of admissions with the diagnosis of pulmonary embolism, their inhospital mortality rates and the population incidence rates...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27913160/psychological-well-being-and-mental-health-recovery-in-the-nimh-raise-early-treatment-program
#19
Julia Browne, David L Penn, Piper S Meyer-Kalos, Kim T Mueser, Sue E Estroff, Mary F Brunette, Christoph U Correll, James Robinson, Robert A Rosenheck, Nina Schooler, Delbert G Robinson, Jean Addington, Patricia Marcy, John M Kane
Recovery-oriented practices that promote client-centered care, collaboration, and functional outcome have been recommended to improve treatment engagement, especially for individuals with serious mental illness (SMI). Psychological well-being (PWB) is related to recovery and refers to experiencing purpose and meaning in life through realizing one's potential. The recently completed Recovery After an Initial Schizophrenia Episode Early Treatment Program (RAISE ETP) study sought to improve quality of life, functional outcome, and well-being in individuals with first episode psychosis (FEP)...
November 29, 2016: Schizophrenia Research
https://www.readbyqxmd.com/read/27908963/anomalous-mesenteric-vessel-a-rare-etiology-of-intermittent-partial-small-bowel-obstruction
#20
Natasha Hansraj, Shannon M Larabee, Kimberly M Lumpkins
We report a case of an 11-year with recurrent episodes of abdominal pain and vomiting. Diagnostic laparoscopy during a severe episode demonstrated an anomalous blood vessel incompletely encircling the bowel, leading to transient partial small bowel obstruction. This likely represents a remnant vessel from the omphalomesenteric duct. Recurrent abdominal pain and vomiting in the pediatric population requires careful history and physical exam, and a willingness to entertain unusual diagnoses.
December 1, 2016: Journal of Surgical Case Reports
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