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https://www.readbyqxmd.com/read/28538964/effect-of-a-modified-hospital-elder-life-program-on-delirium-and-length-of-hospital-stay-in-patients-undergoing-abdominal-surgery-a-cluster-randomized-clinical-trial
#1
Cheryl Chia-Hui Chen, Hsiu-Ching Li, Jin-Tung Liang, I-Rue Lai, Jerry Dwi Trijoyo Purnomo, Yi-Ting Yang, Been-Ren Lin, John Huang, Ching-Yao Yang, Yu-Wen Tien, Chiung-Nien Chen, Ming-Tsan Lin, Guan-Hua Huang, Sharon K Inouye
Importance: Older patients undergoing abdominal surgery commonly experience preventable delirium, which extends their hospital length of stay (LOS). Objective: To examine whether a modified Hospital Elder Life Program (mHELP) reduces incident delirium and LOS in older patients undergoing abdominal surgery. Design, Setting, and Participants: This cluster randomized clinical trial of 577 eligible patients enrolled 377 older patients (≥65 years of age) undergoing gastrectomy, pancreaticoduodenectomy, and colectomy at a 2000-bed urban medical center in Taipei, Taiwan, from August 1, 2009, through October 31, 2012...
May 24, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28538867/preval%C3%A3%C2%AAncia-de-infec%C3%A3-%C3%A3-o-por-helicobacter-pylori-em-uma-comunidade-ind%C3%A3-gena-em-s%C3%A3-o-paulo-e-fatores-associados-estudo-transversalprevalence-of-helicobacter-pylori-infection-in-an-indigenous-community-in-s%C3%A3-o-paulo-and-associated-factors-cross-sectional-study
#2
Juliana Rejane da Silva Roque, Rodrigo Strehl Machado, Douglas Rodrigues, Patrícia Rech, Elisabete Kawakami
CONTEXT AND OBJECTIVE: The prevalence of Helicobacter pylori infection is unevenly distributed among different populations. The aim here was to evaluate the factors associated with Helicobacter pylori infection among children up to five years of age living in a high-risk community. DESIGN AND SETTING: Cross-sectional study in an indigenous community of Guarani Mbya ethnicity, Tekoa Ytu and Tekoa Pyau villages, Jaraguá district, city of São Paulo (SP), Brazil. METHODS: 74 children aged 0...
March 2017: São Paulo Medical Journal, Revista Paulista de Medicina
https://www.readbyqxmd.com/read/28538850/-infection-by-bordetella-pertussis-and-bordetella-parapertussis-in-cases-of-suspected-whooping-cough-2011-2015-in-mar-del-plata-argentina
#3
Silvina Lavayén, Claudia Zotta, Marcela Cepeda, Claudia Lara, Analia Rearte, Mabel Regueira
Objectives: . To classify the study population in the Argentinian National Health Surveillance System framework, determine the proportion of infection by Bordetella pertussis and Bordetella parapertussis, and identify factors associated with the cases of suspected whooping cough attended to in the city of Mar del Plata and its outskirts during the period 2011- 2015. Materials and Methods: An observational and descriptive study was carried out. Clinical cases with suspicion of whooping cough were diagnosed by laboratory...
January 2017: Revista Peruana de Medicina Experimental y Salud Pública
https://www.readbyqxmd.com/read/28538650/consequences-of-pediatric-undertriage-and-overtriage-in-a-statewide-trauma-system
#4
Hilary A Hewes, Mathew Christensen, Peter P Taillac, N Clay Mann, Kammy K Jacobsen, Stephen J Fenton
BACKGROUND: With increasing attention to the quality of health care delivery, evaluating trauma triage decisions in a large system of emergency care can help decision makers reduce mortality, morbidity, unnecessary transfers, and healthcare costs. OBJECTIVES: To quantify the magnitude of pediatric traumatic injury undertriage (hospital mortality risk) and overtriage (early trauma center discharge after transfer) in a statewide trauma system. METHODS: A statewide population-based evaluation of pediatric trauma outcomes and secondary triage (interfacility transfers) patterns from 2001-2013 among 45 hospitals in Utah's statewide trauma system...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538645/increased-mortality-in-trauma-patients-who-develop-post-intubation-hypotension
#5
Robert S Green, Michael B Butler, Mete Erdogan
BACKGROUND: Post-intubation hypotension (PIH) is common and associated with poor outcomes in critically ill patient populations requiring emergency endotracheal intubation (ETI). The importance of PIH in the trauma population remains unclear. The objective of this study was to determine the prevalence of PIH in trauma patients and assess the association of PIH with patient outcomes. METHODS: Retrospective case series of adult (≥16 years) patients who were intubated on arrival at a tertiary trauma center in Halifax, Nova Scotia, Canada between 2000 and 2015...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538640/trends-in-the-epidemiology-of-major-burn-injury-among-hospitalized-patients-a-population-based-analysis
#6
Stephanie A Mason, Avery B Nathens, James Byrne, Alejandro Gonzalez, Rob Fowler, Paul Karanicolas, Rahim Moineddin, Marc G Jeschke
BACKGROUND: Burn-related mortality has decreased significantly over the past several decades. While often attributed in part to regionalization of burn care, this has not been evaluated at the population level. METHODS: We conducted a retrospective, population-based cohort study of all patients with > 20% total burned surface area (TBSA) burn injury in Ontario, Canada. Adult (>16y) patients injured between 2003-2013 were included. Deaths in the emergency department were excluded...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538629/outcomes-following-traumatic-injury-in-patients-with-preexisting-psychiatric-illness
#7
Erika Falsgraf, Kenji Inaba, Amory de Roulet, Megan Johnson, Elizabeth Benjamin, Lydia Lam, Kazuhide Matsushima, Aaron Strumwasser, Demetrios Demetriades
BACKGROUND: Patients with psychiatric illness have been shown to experience higher rates of traumatic injury. Injury patterns, treatment decisions, and outcomes have not been well characterized in patients with psychiatric illness after injury, in particular those who undergo acute surgical intervention. The purpose of this analysis was to determine mortality, complications, and surgical intervention rates in patients with psychiatric illness following traumatic injury. METHODS: This is a retrospective study of trauma patients ≥18 years old admitted to LAC+USC Medical Center between January 2008 and March 2015...
May 22, 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28538609/critical-care-interventions-for-asthmatic-patients-admitted-from-the-emergency-department-to-the-pediatric-intensive-care-unit
#8
Kristen Michelle Cundiff, James M Gerard, Robert G Flood
OBJECTIVES: The aim of this study was to assess the frequency and predictors of critical interventions in asthmatic patients admitted to the pediatric intensive care unit (PICU) at a tertiary-care pediatric hospital. METHODS: We conducted a retrospective chart review of patients admitted from our emergency department (ED) to the PICU for treatment of status asthmaticus between January 1, 2008, and March 31, 2013. Patients with concomitant medical conditions and those who received a critical intervention, other than continuously aerosolized albuterol, in the ED before admission were excluded...
May 23, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28538606/assessing-severity-in-pediatric-pneumonia-predictors-of-the-need-for-major-medical-interventions
#9
Are Stuwitz Berg, Christopher Stephen Inchley, Hans Olav Fjaerli, Truls Michael Leegaard, Britt Nakstad
OBJECTIVE: The aim of this study was to determine potential predictors of the need for major medical interventions in the context of assessing severity in pediatric pneumonia. METHODS: This was a prospective, cohort study of previously healthy children and adolescents younger than 18 years presenting to the pediatric emergency room with clinically suspected pneumonia and examining both the full cohort and those with radiologically confirmed pneumonia. The presence of hypoxemia (peripheral oxygen saturation ≤92%), age-specific tachypnea, high temperature (≥38...
May 23, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/28538598/the-need-for-multidimensional-stratification-of-chronic-low-back-pain-lbp
#10
Yoga Raja Rampersaud, Andrew Bidos, Caroline Fanti, Anthony V Perruccio
STUDY DESIGN: Cross-sectional study of Canadian LBP patients seeking primary care. OBJECTIVE: Determine which existing primary care LBP stratification schema is associated with distinct sub-populations as characterized by easily identifiable primary epidemiological factors. SUMMARY OF BACKGROUND DATA: Low back pain (LBP) is among the most frequent reasons for visits to primary care physicians and a leading cause of years lived with disability...
May 22, 2017: Spine
https://www.readbyqxmd.com/read/28538595/after-posterior-fusions-for-adult-spinal-deformity-operative-time-is-more-predictive-of-perioperative-morbidity-rather-than-surgical-invasiveness-a-need-for-speed
#11
Andre M Samuel, Michael C Fu, Nidharshan S Anandasivam, Matthew L Webb, Adam M Lukasiewicz, Han Jo Kim, Jonathan N Grauer
STUDY DESIGN: Retrospective cohort study OBJECTIVE.: To determine the independent effects of operative time and surgical invasiveness on perioperative outcomes after posterior spinal fusions for adult spinal deformity. SUMMARY OF BACKGROUND DATA: Morbidity is high after posterior fusions for adult spinal deformity. While previous reports have demonstrated an association between perioperative outcomes and the extent of correction and fusion (number of posterior levels fused, pelvic fixation, combined anterior-posterior fusion), no study has looked at the independent effects of the surgical invasiveness after controlling for operative time...
May 22, 2017: Spine
https://www.readbyqxmd.com/read/28538559/a-review-of-101-consecutive-subcutaneous-mastectomies-and-male-chest-contouring-using-the-concentric-circular-and-free-nipple-graft-techniques-in-female-to-male-transgender-patients
#12
Aaron D C Knox, Adelyn L Ho, Leslie Leung, Sally Hynes, A Yashar Tashakkor, Yoon Soo Park, Sheina A Macadam, Cameron C Bowman
BACKGROUND: Many techniques exist for subcutaneous mastectomy in female-to-male transgender patients. The authors review outcomes for two techniques and present an algorithm to aid surgeons in technique selection. METHODS: One hundred one consecutive female-to-male transgender patients undergoing subcutaneous mastectomy using the concentric circular or free nipple graft technique were retrospectively reviewed. An algorithm for procedure selection was created using classification and regression tree analysis...
June 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28538553/the-effect-of-resident-involvement-on-postoperative-short-term-surgical-outcomes-in-immediate-breast-reconstruction-a-national-surgical-quality-improvement-program-study-of-24-005-patients
#13
Mohamad E Sebai, Ricardo J Bello, Scott D Lifchez, Damon S Cooney, Gedge D Rosson, Carisa M Cooney
BACKGROUND: The association between resident involvement and surgical morbidity in immediate breast reconstruction is not fully elucidated, and prior studies have had conflicting results. The authors studied whether resident involvement in immediate breast reconstruction is associated with the most important short-term outcomes: increased 30-day surgical morbidity, readmission and reoperation rates, operative time, and length of stay. METHODS: Patients undergoing immediate breast reconstruction were identified in the 2005 to 2012 American College of Surgeons National Surgical Quality Improvement Program Participant Use Data Files...
June 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28538508/central-nervous-system-disease-education-and-race-impact-radiation-refusal-in-pediatric-cancer-patients
#14
Chirayu G Patel, Mark Stavas, Stephanie Perkins, Eric T Shinohara
To investigate the determinants of radiation therapy refusal in pediatric cancer, we used the Surveillance, Epidemiology, and End Results registry to identify 24,421 patients who met the eligibility criteria, diagnosed between 1974 and 2012. Patients had any stage of cancer, were aged 0 to 19, and received radiation therapy or refused radiation therapy when it was recommended. One hundred twenty-eight patients (0.52%) refused radiation therapy when it was recommended. Thirty-two percent of patients who refused radiation therapy ultimately died from their cancer, at a median of 7 months after diagnosis (95% confidence interval, 3-11 mo), as compared with 29...
May 22, 2017: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/28538443/an-airway-management-protocol-after-anterior-cervical-spine-surgery-analysis-the-results-of-risk-factors-associated-with-airway-complication
#15
Moinay Kim, Il Choi, Jin Hoon Park, Sang Ryong Jeon, Seung Chul Rhim, Sung Woo Roh
STUDY DESIGN: Retrospective comparative cohort analysis. OBJECTIVE: To evaluate the effect of postoperative airway management protocol (ASAN Extubation Protocol, AEP) on incidence of airway complications for patients undergoing anterior cervical spine surgery (ACSS). SUMMARY OF BACKGROUND DATA: Postoperative airway compromise remains crucial for patients undergoing ACSS. Despite the potential severity of these complications, the data in the published literature addressing this issue is sparse...
May 19, 2017: Spine
https://www.readbyqxmd.com/read/28538442/impact-of-moderate-hyperchloremia-on-clinical-outcomes-in-intracerebral-hemorrhage-patients-treated-with-continuous-infusion-hypertonic-saline-a-pilot-study
#16
Heidi M Riha, Michael J Erdman, Joseph E Vandigo, Lauren A Kimmons, Nitin Goyal, K Erin Davidson, Abhi Pandhi, G Morgan Jones
OBJECTIVES: Hyperchloremia has been associated with increased morbidity and mortality in critically ill patients. While previous research has demonstrated an association between hypertonic saline and hyperchloremia, limited data exist in neurocritical care patients. The objective of this study is to determine the impact of moderate hyperchloremia (chloride ≥ 115 mmol/L) on clinical outcomes in intracerebral hemorrhage patients treated with continuous IV infusion 3% hypertonic saline...
May 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28538440/neurologic-injury-in-adults-supported-with-veno-venous-extracorporeal-membrane-oxygenation-for-respiratory-failure-findings-from-the-extracorporeal-life-support-organization-database
#17
Roberto Lorusso, Sandro Gelsomino, Orlando Parise, Michele Di Mauro, Fabio Barili, Gijs Geskes, Enrico Vizzardi, Peter T Rycus, Raf Muellenbach, Thomas Mueller, Antonio Pesenti, Alain Combes, Giles Peek, Bjorn Frenckner, Matteo Di Nardo, Justyna Swol, Jos Maessen, Ravi R Thiagarajan
OBJECTIVES: To assess in-hospital neurologic (CNS) complications in adult patients undergoing veno-venous extracorporeal membrane oxygenation for respiratory failure. DESIGN: Retrospective analysis of the Extracorporeal Life Support Organization's data registry. SETTING: Data reported to Extracorporeal Life Support Organization from 350 international extracorporeal membrane oxygenation centers during 1992-2015. PATIENTS: Adults (≥ 18 yr old) supported with veno-venous extracorporeal membrane oxygenation for respiratory failure...
May 22, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28538421/malnutrition-is-associated-with-hiv-infection-in-children-less-than-5-years-in-bobo-dioulasso-city-burkina-faso-a-case-control-study
#18
Ghislain Gnimbar Poda, Chien-Yeh Hsu, Jane C-J Chao
Pediatric human immunodeficiency virus (HIV) infection and malnutrition are still 2 major health issues in sub-Saharan Africa including Burkina Faso where few studies have been conducted on child malnutrition and HIV infection. This study assessed the effects of antiretroviral therapy (ART) in HIV infection and also compared the prevalence of malnutrition in terms of an inadequate diet, underweight, stunting, and wasting among HIV-infected and uninfected children less than 5 years in Bobo-Dioulasso city, Burkina Faso...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28538414/clinical-predictors-for-the-manifestation-of-late-gadolinium-enhancement-after-acute-myocardial-infarction
#19
Nadine Abanador-Kamper, Lars Kamper, Marc Vorpahl, Hilmar Brinkmann, Vasiliki Karamani, Patrick Haage, Melchior Seyfarth
Despite prompt revascularization, some patients with acute myocardial infarction (AMI) develop myocardial scars, which can be visualized by late gadolinium enhancement (LGE) in cardiovascular magnetic resonance imaging (CMR). Our goal was to identify angiographic findings that were predictive for scar development in patients after reperfused AMI.We examined 136 patients after first ST-elevated myocardial infarction by CMR after a median of 4 days (range: 2-7). Patients with manifestation of LGE were matched to patients without LGE by means of age and gender...
May 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28538411/gender-difference-in-the-association-between-aminotransferase-levels-and-hypertension-in-a-chinese-elderly-population
#20
Lei Wu, Yao He, Bin Jiang, Miao Liu, Shanshan Yang, Yiyan Wang, Jing Zeng, Yao Yao, Jianhua Wang
Few epidemiological studies have examined the association between serum aminotransferase levels and hypertension, and have yielded inconsistent results.A cross-sectional study was performed in a Chinese rural elderly population. A total of 2174 participants with normal range of aminotransferase levels and without excessive drinking were included in the present study. Alanine aminotransferase (ALT) and aspartate aminotransferase (AST) levels were measured on fasting morning serum samples using the Kinetic method...
May 2017: Medicine (Baltimore)
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