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https://www.readbyqxmd.com/read/28823090/epidural-patch-with-autologous-platelet-rich-plasma-a-novel-approach
#1
Berrin Gunaydin, Muberra Acar, Gokcen Emmez, Didem Akcali, Nil Tokgoz
We aimed to perform an epidural patch using platelet rich plasma (PRP), which has the potential to regenerate and heal tissues via degranulation of platelets, in a 34-year-old parturient suffering from persistent post-dural puncture headache (PDPH) after failed epidural blood patch (EBP). After her admission to our unit, we reconfirmed the clinical and radiologic diagnosis of PDPH. Cranial MRI with contrast showed diffuse pachymeningeal thickening and contrast enhancement with enlarged pituitary consistent with intracranial hypotension...
August 19, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28823070/-what-is-not-written-does-not-exist-the-importance-of-proper-documentation-of-medication-use-history
#2
Carina Carvalho Silvestre, Lincoln Marques Cavalcante Santos, Alfredo Dias de Oliveira-Filho, Divaldo Pereira de Lyra
Medications are perceived as health risk factors, because they might cause damage if used improperly. In this context, an adequate assessment of medication use history should be encouraged, especially in transitions of care to avoid unintended medication discrepancies (UMDs). In a case-controlled study, we investigated potential risk factors for UMDs at hospital admission and found that 150 (42%) of the 358 patients evaluated had one or more UMDs. We were surprised to find that there was no record of a patient and/or relative interview on previous use of medication in 117 medical charts of adult patients (44...
August 19, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28822857/exploring-associations-of-clinical-and-social-parameters-with-violent-behaviors-among-psychiatric-patients
#3
Hong-Jie Dai, Emily Chia-Yu Su, Mohy Uddin, Jitendra Jonnagaddala, Chi-Shin Wu, Shabbir Syed-Abdul
Evidence has revealed interesting associations of clinical and social parameters with violent behaviors of patients with psychiatric disorders. Men are more violent preceding and during hospitalization, whereas women are more violent than men throughout the 3 days following a hospital admission. It has also been proven that mental disorders may be a consistent risk factor for the occurrence of violence. In order to better understand violent behaviors of patients with psychiatric disorders, it is important to investigate both the clinical symptoms and psychosocial factors that accompany violence in these patients...
August 16, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28822759/a-case-of-epistaxis
#4
A Debelmas, S Lanciaux, T Schouman
The authors report a case of epistaxis in a 74-year-old male patient. His recent medical history documented recurrent nasal bleeding and a Le Fort 1 osteosynthesis 3 weeks before admission to our unit.
August 16, 2017: Journal of Stomatology, Oral and Maxillofacial Surgery
https://www.readbyqxmd.com/read/28822736/-rhinovirus-underestimated-pathogens-in-patients-during-the-neonatal-period
#5
S Zacharie, A Vabret, B Guillois, C Dupont, J Brouard
INTRODUCTION: In recent years, developments in virological tools have led to the easy detection of rhinoviruses and enteroviruses (E/RV). Their detection is very frequent in cases of airway involvement in children and their demonstrated causality. But the morbidity of E/RV in the neonatal period is unknown due to lack of epidemiological data. The objective of this study was to evaluate the incidence and clinical characteristics of these infections in hospitalized neonates. MATERIALS AND METHODS: We retrospectively analyzed the virology specimens of all neonates hospitalized at the Caen University Hospital between 2006 and 2011...
August 16, 2017: Archives de Pédiatrie: Organe Officiel de la Sociéte Française de Pédiatrie
https://www.readbyqxmd.com/read/28822713/incidence-of-cross-infection-in-liver-transplant-patients-risk-factors-and-role-of-nursinge
#6
M Carmen Cierco Garrido, Raquel García Muñoz, Immaculada Pérez Castro, Miquel Sanz Moncusi
OBJECTIVE: To determine the incidence and risk factors of infection in liver transplant recipients immediately post-transplant, during admission to a liver transplant unit during the immediate post-transplant admission. METHODOLOGY: Descriptive, prospective study performed in the Liver Transplant Unit of Hospital Clínic, Barcelona. All liver transplant recipients between January 2012 and August 2015 (n=241) were included. Statistical analysis was performed with R Commander...
August 16, 2017: Enfermería Clínica
https://www.readbyqxmd.com/read/28822711/efficacy-of-passive-hypothermia-and-adverse-events-during-transport-of-asphyxiated-newborns-according-to-the-severity-of-hypoxic-ischemic-encephalopathy
#7
Nuria Carreras, Miguel Alsina, Ana Alarcon, Gemma Arca-Díaz, Thais Agut, Alfredo García-Alix
OBJECTIVE: To determine if the efficacy of passive hypothermia and adverse events during transport are related to the severity of neonatal hypoxic-ischemic encephalopathy (HIE). METHODS: This was a retrospective study of 67 infants with HIE, born between April 2009 and December 2013, who were transferred for therapeutic hypothermia and cooled during transport. RESULTS: Fifty-six newborns (84%) were transferred without external sources of heat and 11 (16%) needed an external heat source...
August 17, 2017: Jornal de Pediatria
https://www.readbyqxmd.com/read/28822702/antibody-mediated-extreme-insulin-resistance-a-report-of-three-cases
#8
Han Na Kim, Betiel Fesseha, Laura Anzaldi, Allison Tsao, Panagis Galiatsatos, Aniket Sidhaye
BACKGROUND: Type 2 diabetes mellitus is characterized by relative insulin deficiency and insulin resistance. Features suggesting severe insulin resistance include acanthosis nigricans, hyperandrogenism, weight loss, and recurrent hospital admissions for diabetic ketoacidosis. In rare circumstances, hyperglycemia persists despite administration of massive doses of insulin. In these cases, it is important to consider autoimmune etiologies for insulin resistance such as type B insulin resistance and insulin antibody-mediated extreme insulin resistance, which carry high morbidity and mortality if untreated...
August 16, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28822665/the-associations-of-hemodialysis-access-type-and-access-satisfaction-with-health-related-quality-of-life
#9
Natalie Domenick Sridharan, Larry Fish, Lan Yu, Steven Weisbord, Manisha Jhamb, Michel S Makaroun, Theodore H Yuo
OBJECTIVE: In addition to age and comorbidities, health-related quality of life (HRQOL) is known to predict mortality in hemodialysis (HD) patients. Understanding the association of vascular access type with HRQOL can help surgeons to provide patient-centered dialysis access recommendations. We sought to understand the impact of HD access type on HRQOL. METHODS: We conducted a cross-sectional prospective study of community-dwelling prevalent HD patients in Pittsburgh, Pennsylvania...
August 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28822661/preoperative-anemia-associated-with-adverse-outcomes-after-infrainguinal-bypass-surgery-in-patients-with-chronic-limb-threatening-ischemia
#10
Thomas C F Bodewes, Alexander B Pothof, Jeremy D Darling, Sarah E Deery, Douglas W Jones, Peter A Soden, Frans L Moll, Marc L Schermerhorn
OBJECTIVE: Preoperative anemia in elderly patients undergoing surgery is prevalent and associated with adverse events; however, the interaction with other risk factors in patients with chronic limb-threatening ischemia (CLTI) is not well described. The purpose of this study was to assess the association between lower hematocrit (HCT) levels on admission and postoperative outcomes after infrainguinal bypass surgery. METHODS: Patients with CLTI undergoing nonemergent infrainguinal bypass were identified in the targeted vascular module of National Surgical Quality Improvement Program (NSQIP; 2011-2014)...
August 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28822398/variability-in-perioperative-fasting-practices-negatively-impacts-nutritional-support-of-critically-ill-intubated-patients
#11
Molly J Douglas, David Ciraulo
The aim of the study was to quantify nutritional losses related to pre- and postoperative fasts in critically ill intubated patients and to explore whether shorter fasts are safe and appropriate in this population. A retrospective review of mechanically ventilated adults undergoing surgery more than 24 hours after admission to a Level I trauma center over 15 months was done, which yielded 132 procedures and 81 unique patients. Ninety per cent of preoperative periods and 43 per cent of postoperative periods were affected by nonmedical barriers to feeding...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28822393/identifying-futile-interfacility-surgical-transfers
#12
Kristy Kummerow Broman, Sharon E Phillips, Jesse M Ehrenfeld, Mayur B Patel, Oscar M Guillamondegui, Kenneth W Sharp, Richard A Pierce, Benjamin K Poulose, Michael D Holzman
Surgeons perceive that some surgical transfers are futile, but the incidence and risk factors of futile transfer are not quantified. Identifying futile interfacility transfers could save cost and undue burdens to patients and families. We sought to describe the incidence and factors associated with futile transfers. We conducted a retrospective cohort study from 2009 to 2013 including patients transferred to a tertiary referral center for general or vascular surgical care. Futile transfers were defined as resulting in death or hospice discharge within 72 hours of transfer without operative, endoscopic, or radiologic intervention...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28822387/indicators-of-survival-and-favorable-functional-outcomes-after-decompressive-craniectomy-a-multi-institutional-retrospective-study
#13
Abid D Khan, Anna J Elseth, Brian Head, Jack Rostas, Julie A Dunn, Thomas J Schroeppel, Richard P Gonzalez
The role of decompressive craniectomy (DC) for severe traumatic brain injury (STBI) remains controversial. The purpose of this study was to identify factors that are indicators of survival and improved functional outcome in patients who undergo DC for STBI. A retrospective review of STBI patients who underwent DC was performed at four trauma centers during a 45-month period. Data collected included age, gender, mechanism of injury, Injury Severity Score (ISS), admission Glasgow Coma Scale (GCS), time from admission to DC, mortality, and extended Glasgow Outcome Score before discharge...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28822384/clinical-characteristics-of-trauma-patients-requiring-hydrocortisone-treatment-for-refractory-hypotension
#14
Gina Kim, Jeffrey Young
Corticosteroids play an important role in responding to physiologic stress in the human body. However, its application in critical care remains heavily debated. The purpose of this study was to identify patient characteristics associated with receiving stress-dose steroids during the intensive care unit stay after traumatic injury and its effect on in-hospital mortality. Patients admitted to the University of Virginia trauma center between January 1, 2011, and December 31, 2015, were identified using our Trauma Registry...
August 1, 2017: American Surgeon
https://www.readbyqxmd.com/read/28822255/malnutrition-in-postacute-geriatric-care-basic-espen-diagnosis-and-etiology-based-diagnoses-analyzed-by-length-of-stay-in-hospital-mortality-and-functional-rehabilitation-indexes
#15
Dolores Sánchez-Rodríguez, Ester Marco, Cédric Annweiler, Natalia Ronquillo-Moreno, Andrea Tortosa, Olga Vázquez-Ibar, Ferran Escalada, Xavier Duran, Josep M Muniesa
OBJECTIVE: To determine the relationships between malnutrition and nutrition-related conditions according to the European Society of Clinical Nutrition and Metabolism (ESPEN) consensus and guidelines and clinical outcomes in postacute rehabilitation. METHODS: Of 102 eligible inpatients, 95 (84.5 years old, 63.2% women) fulfilled inclusion criteria: aged ≥70 years, body mass index <30kg/m(2), admission for rehabilitation. Mini-Nutritional Assessment-Short Form (MNA-SF≤11) identified patients "at risk" and ESPEN basic and etiology based definitions were applied...
August 2, 2017: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/28821941/rheumatologic-care-of-nursing-home-residents-with-rheumatoid-arthritis-a-comparison-of-the-year-before-and-after-nursing-home-admission
#16
Andres Luque Ramos, Katinka Albrecht, Angela Zink, Falk Hoffmann
The purpose of this study was to investigate health care for patients with rheumatoid arthritis (RA) before and after admission to nursing homes. Data of a German health insurance fund from persons with diagnostic codes of RA, aged ≥65 years, admitted to a nursing home between 2010 and 2014 and continuously insured 1 year before and after admission were used. The proportion of patients with ≥1 rheumatologist visit and ≥1 prescription of biologic or conventional synthetic disease-modifying antirheumatic drugs (bDMARDs or csDMARDs), glucocorticoids and non-steroidal anti-inflammatory drugs (NSAIDs) in the year before and after admission were calculated...
August 18, 2017: Rheumatology International
https://www.readbyqxmd.com/read/28821915/risk-and-outcomes-of-fracture-in-peripheral-arterial-disease-patients-two-nationwide-cohort-studies
#17
F-L Liu, C-S Lin, C-C Yeh, C-C Shih, Y-G Cherng, C-H Wu, T-L Chen, C-C Liao
Using national insurance claims data of Taiwan, we found that patients with peripheral arterial disease (PAD) had increased risk of fracture during the follow-up period of 2000-2013. History of PAD was also associated with adverse outcomes in hospitalized fracture patients. Prevention strategies were needed in this susceptible population. INTRODUCTION: Limited information was available on the association between PAD and fracture. The purpose of this study is to evaluate fracture risk and post-fracture outcomes in patients with PAD...
August 18, 2017: Osteoporosis International
https://www.readbyqxmd.com/read/28821524/the-association-between-intensive-care-unit-acquired-hypernatraemia-and-mortality-in-critically-ill-patients-with-cerebrovascular-diseases-a-single-centre-cohort-study-in-japan
#18
Takahiro Imaizumi, Masahiro Nakatochi, Yoshiro Fujita, Rie Nomura, Kenshi Watanabe, Michitaka Maekawa, Taishi Yamakawa, Takayuki Katsuno, Shoichi Maruyama
OBJECTIVES: Hypernatraemia is one of the major electrolyte disorders associated with mortality among critically ill patients in intensive care units (ICUs). It is unclear whether this applies to patients with cerebrovascular diseases in whom high sodium concentrations may be allowed in order to prevent cerebral oedema. This study aimed to examine the association between ICU-acquired hypernatraemia and the prognosis of patients with cerebrovascular diseases. DESIGN: A retrospective cohort study...
August 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28821454/low-dose-anti-thymocyte-globulin-for-graft-versus-host-disease-prophylaxis-in-matched-unrelated-allogeneic-hematopoietic-stem-cell-transplant
#19
A Bryant, R Mallick, L Huebsch, D Allan, H Atkins, G Anstee, M Sabloff, N Scrivens, D Maze, C Bredeson, N Kekre
Graft-versus-host disease (GVHD) is a leading cause of morbidity and mortality in allogeneic hematopoietic stem cell transplantation (alloHCT). Prophylactic in-vivo T-Cell depletion with antithymocyte globulin (ATG) has been associated with decreased GVHD rates many alloHCT settings. Despite decades of clinical study, optimal ATG dosing has not been established. Understanding that higher rates of GVHD are observed with matched unrelated (MUD) versus matched related donor (MRD) alloHCT, at our institution MUD alloHSCT recipients have historically had low dose thymoglobulin (total dose 2...
August 15, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28821444/circumferential-fusion-a-comparative-analysis-between-anterior-lumbar-interbody-fusion-with-posterior-pedicle-screw-fixation-and-transforaminal-lumbar-interbody-fusion-for-l5-s1-isthmic-spondylolisthesis
#20
Erik Y Tye, Joseph E Tanenbaum, Andrea S Alonso, Roy Xiao, Michael P Steinmetz, Thomas E Mroz, Jason W Savage
BACKGROUND CONTEXT: Transforaminal lumbar interbody fusion (TLIF) or anterior lumbar interbody fusion with percutaneous pedicle screws (ALIFPS) offer significantly higher radiographic fusion rates than other fusion techniques for L5-S1 isthmic spondylolisthesis (IS). As it stands, there is a relative paucity of comparative data of the two techniques. PURPOSE: To define the clinical, radiographic, and financial differences between TLIF and ALIFPS for L5-S1 IS. STUDY DESIGN/SETTING: A retrospective cohort study conducted at a single-tertiary care center...
August 15, 2017: Spine Journal: Official Journal of the North American Spine Society
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