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Ahmadreza Argha, Andrey Savkin, Siaw-Teng Liaw, Branko George Celler
BACKGROUND: Seasonal variation has an impact on the hospitalization rate of patients with a range of cardiovascular diseases, including myocardial infarction and angina. This paper presents findings on the influence of seasonal variation on the results of a recently completed national trial of home telemonitoring of patients with chronic conditions, carried out at five locations along the east coast of Australia. OBJECTIVE: The aim is to evaluate the effect of the seasonal timing of hospital admission and length of stay on clinical outcome of a home telemonitoring trial involving patients (age: mean 72...
March 16, 2018: JMIR Medical Informatics
Ali Abdolahnejad, Negar Jafari, Amir Mohammadi, Mohammad Miri, Yaghoub Hajizadeh
Background: The presence of air pollutants such as CO, NO2 , SO2 , O3 , and PM in the ambient air mainly emitted from fossil fuels combustion has become a major health concern. The aims of this study were to estimate the attribution of NO2 , SO2 , and O3 in the premature deaths and prevalence of cardiovascular and respiratory diseases in Isfahan in 2013-2014. Methods: In this study, short-term health effects (total mortality, cardiovascular and respiratory mortality, chronic obstructive pulmonary disease, and acute myocardial infarction) of exposure NO2 , SO2 , and O3 on the population of Isfahan were assessed using AirQ 2...
2018: International Journal of Preventive Medicine
Irene Papanicolas, Liana R Woskie, Ashish K Jha
Importance: Health care spending in the United States is a major concern and is higher than in other high-income countries, but there is little evidence that efforts to reform US health care delivery have had a meaningful influence on controlling health care spending and costs. Objective: To compare potential drivers of spending, such as structural capacity and utilization, in the United States with those of 10 of the highest-income countries (United Kingdom, Canada, Germany, Australia, Japan, Sweden, France, the Netherlands, Switzerland, and Denmark) to gain insight into what the United States can learn from these nations...
March 13, 2018: JAMA: the Journal of the American Medical Association
Rocco Friebel, Katharina Hauck, Paul Aylin, Adam Steventon
OBJECTIVE: To assess trends in 30-day emergency readmission rates across England over one decade. DESIGN: Retrospective study design. SETTING: 150 non-specialist hospital trusts in England. PARTICIPANTS: 23 069 134 patients above 18 years of age who were readmitted following an initial admission (n=62 584 297) between April 2006 and February 2016. PRIMARY AND SECONDARY OUTCOMES: We examined emergency admissions that occurred within 30 days of discharge from hospital ('emergency readmissions') as a measure of healthcare quality...
March 12, 2018: BMJ Open
Laurien Goedemans, Rachid Abou, Georgette E Hoogslag, Nina Ajmone Marsan, Victoria Delgado, Jeroen J Bax
Aims: Left ventricular (LV) systolic function is a known prognostic factor after ST-segment elevation myocardial infarction (STEMI). We evaluated the prognostic value of LV global longitudinal strain (GLS) in patients with chronic obstructive pulmonary disease (COPD) after STEMI. Methods and results: One hundred and forty-three STEMI patients with COPD (mean age 70 ± 11 years, 71% male), were retrospectively analysed. Left ventricular ejection fraction (LVEF) and LV GLS were measured on transthoracic echocardiography within 48 h of admission...
February 26, 2018: European Heart Journal Cardiovascular Imaging
Marlous Hall, Tatendashe B Dondo, Andrew T Yan, Mamas A Mamas, Adam D Timmis, John E Deanfield, Tomas Jernberg, Harry Hemingway, Keith A A Fox, Chris P Gale
BACKGROUND: There is limited knowledge of the scale and impact of multimorbidity for patients who have had an acute myocardial infarction (AMI). Therefore, this study aimed to determine the extent to which multimorbidity is associated with long-term survival following AMI. METHODS AND FINDINGS: This national observational study included 693,388 patients (median age 70.7 years, 452,896 [65.5%] male) from the Myocardial Ischaemia National Audit Project (England and Wales) who were admitted with AMI between 1 January 2003 and 30 June 2013...
March 2018: PLoS Medicine
Johannes M I H Gho, Amand F Schmidt, Laura Pasea, Stefan Koudstaal, Mar Pujades-Rodriguez, Spiros Denaxas, Anoop D Shah, Riyaz S Patel, Chris P Gale, Arno W Hoes, John G Cleland, Harry Hemingway, Folkert W Asselbergs
OBJECTIVES: To investigate the incidence and determinants of heart failure (HF) following a myocardial infarction (MI) in a contemporary cohort of patients with MI using routinely collected primary and hospital care electronic health records (EHRs). METHODS: Data were used from the CALIBER programme, linking EHRs in England from primary care, hospital admissions, an MI registry and mortality data. Subjects were eligible if they were 18 years or older, did not have a history of HF and survived a first MI...
March 3, 2018: BMJ Open
Alfred Burger, Chad Miller, Bradley A Sharpe, Rachel E Thompson
BACKGROUND: Hospital Medicine has a widening scope of practice. This article provides a summary of recent highimpact publications for busy clinicians who provide care to hospitalized adults. METHODS: The authors reviewed articles published between March 2016 and March 2017 for the Update in Hospital Medicine presentations at the 2017 Society of Hospital Medicine and Society of General Internal Medicine annual meetings. Nine of the 20 articles presented were selected for this review based on the article quality and potential to influence practice...
February 27, 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
Daniel A Waxman, Hemal K Kanzaria, David L Schriger
Importance: The Institute of Medicine described diagnostic error as the next frontier in patient safety and highlighted a critical need for better measurement tools. Objectives: To estimate the proportions of emergency department (ED) visits attributable to symptoms of imminent ruptured abdominal aortic aneurysm (AAA), acute myocardial infarction (AMI), stroke, aortic dissection, and subarachnoid hemorrhage (SAH) that end in discharge without diagnosis; to evaluate longitudinal trends; and to identify patient characteristics independently associated with missed diagnostic opportunities...
February 26, 2018: JAMA Internal Medicine
Jens M Hohlfeld, Jens Vogel-Claussen, Heike Biller, Dominik Berliner, Korbinian Berschneider, Hanns-Christian Tillmann, Simone Hiltl, Johann Bauersachs, Tobias Welte
BACKGROUND: Pulmonary hyperinflation in chronic obstructive pulmonary disease (COPD) is associated with reduced biventricular end-diastolic volumes and increased morbidity and mortality. The combination of a long-acting β agonist (LABA) and a muscarinic antagonist (LAMA) is more effective in reducing hyperinflation than LABA-inhaled corticosteroid combination therapy but whether dual bronchodilation improves cardiac function is unknown. METHODS: We did a double-blind, randomised, two-period crossover, placebo-controlled, single-centre study (CLAIM) at the Fraunhofer Institute of Toxicology and Experimental Medicine (Hannover, Germany), a specialty clinic...
February 21, 2018: Lancet Respiratory Medicine
Christoph Hanefeld, Alexander Haschemi, Thomas Lampert, Hans J Trampisch, Andreas Mügge, Janine Miebach, Cordula Kloppe, Renate Klaaßen-Mielke
BACKGROUND: Persons of lower socio-economic status are at higher risk of disease, especially with respect to severe and chronic illnesses. To date, there have not been any studies with large case numbers regarding acute medical emergencies in this population. METHODS: In a retrospective study, data were obtained on all cases treated by emergency physicians in Bochum, Germany, in 2014/2015, including the diagnoses that were made by the emergency physicians. There were a total of 16 767 cases...
January 26, 2018: Deutsches Ärzteblatt International
Neil M Davies, Gemma M J Taylor, Amy E Taylor, Timothy Jones, Richard M Martin, Marcus R Munafò, Frank Windmeijer, Kyla H Thomas
AIMS: To investigate whether smokers prescribed varenicline had lower risks of serious ill-health during the 4 years following treatment compared with those prescribed nicotine replacement therapy (NRT). DESIGN: Observational cohort study of electronic medical records. SETTING: A total of 370 UK general practices sampled from the Clinical Practice Research Datalink. PARTICIPANTS: A total of 126 718 patients aged 18 and over who were issued smoking cessation prescriptions between 1 September 2006 and 31 March 2014...
February 20, 2018: Addiction
Janet M C Ngu, Ming Hao Guo, David Glineur, Diem Tran, Fraser D Rubens
OBJECTIVES: There is growing interest in the use of bilateral internal thoracic arteries (BITAs) for myocardial revascularization. This study sought to compare the balance between early benefits and long-term outcomes of skeletonized or non-skeletonized conduits and to determine whether differences in outcomes are affected by other patient risk factors. METHODS: BITAs were used in 1504 cases with either SK or NSK conduits. Propensity matching was completed using 22 covariates identifying 441 pairs of patients...
February 13, 2018: European Journal of Cardio-thoracic Surgery
Ken M Kunisaki, Mark T Dransfield, Julie A Anderson, Robert D Brook, Peter M A Calverley, Bartolome R Celli, Courtney Crim, Benjamin F Hartley, Fernando J Martinez, David E Newby, Alexa A Pragman, Jørgen Vestbo, Julie C Yates, Dennis E Niewoehner
RATIONALE: Acute exacerbations of chronic obstructive pulmonary disease (AECOPD) are common, associated with acute inflammation, and may increase subsequent cardiovascular disease (CVD) risk. OBJECTIVE: Determine if AECOPD events are associated with increased risk of subsequent CVD. METHODS: A secondary cohort analysis of the Study to Understand Mortality and MorbidITy (SUMMIT) trial, a convenience sample of current/former smokers with moderate COPD from 1,368 centers in 43 countries...
February 14, 2018: American Journal of Respiratory and Critical Care Medicine
Daniela Simões, Fábio Azevedo Araújo, Teresa Monjardino, Milton Severo, Ivo Cruz, Loreto Carmona, Raquel Lucas
The aim of this study was to quantify the population impact of rheumatic and musculoskeletal diseases (RMDs) with other non-communicable diseases (NCDs), using two complementary strategies: standard multivariate models based on global burden of disease (GBD)-defined groups vs. empirical mutually exclusive patterns of NCDs. We used cross-sectional data from the Portuguese Fourth National Health Survey (n = 23,752). Six GBD-defined groups were included: RMDs, chronic obstructive pulmonary disease or asthma, cancer, depression, diabetes or renal failure, and stroke or myocardial infarction...
February 8, 2018: Rheumatology International
George A Yakubek, Gannon L Curtis, Nipun Sodhi, Mhamad Faour, Alison K Klika, Michael A Mont, Wael K Barsoum, Carlos A Higuera
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a leading cause of morbidity and mortality. Furthermore, COPD patients are at increased risk of complications following surgery. The purpose of this study was to evaluate the postoperative total hip arthroplasty (THA) outcomes of COPD patients. Specifically, we asked the following questions: (1) Is COPD associated with adverse perioperative outcomes and (2) Does COPD increase the risk of short-term complications following THA? METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was used to identify 64,796 patients who underwent THA between 2008 and 2014...
January 9, 2018: Journal of Arthroplasty
Lianping Yang, Chaojie Liu, Cunrui Huang, Dana B Mukamel
BACKGROUND: Reducing 30-day hospital readmissions has become a focus of the current national payment policies. Medicare requires that hospitals collect and report patients' experience with their care as a condition of payment. However, the extent to which patients' experience with hospital care is related to hospital readmission is unknown. METHODS: We established multivariate regression models in which 30-day risk-adjusted readmission rates were the dependent variables and patients' perceptions of the responsiveness of the hospital staff and communication (as measured by the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) scores) were the independent variables of interest...
January 29, 2018: BMC Health Services Research
Timothy J Daskivich, Garen Abedi, Sherrie H Kaplan, Douglas Skarecky, Thomas Ahlering, Brennan Spiegel, Mark S Litwin, Sheldon Greenfield
OBJECTIVES: To determine whether comorbidity information derived from electronic health record (EHR) problem lists is accurate. STUDY DESIGN: Retrospective cohort study of 1596 men diagnosed with prostate cancer between 1998 and 2004 at 2 Southern California Veterans Affairs Medical Centers with long-term follow-up. METHODS: We compared EHR problem list-based comorbidity assessment with manual review of EHR free-text notes in terms of sensitivity and specificity for identification of major comorbidities and Charlson Comorbidity Index (CCI) scores...
January 1, 2018: American Journal of Managed Care
Michel Komajda, Mathieu Kerneis, Luigi Tavazzi, Serban Balanescu, Francesco Cosentino, Alberto Cremonesi, Roberto Ferrari, Serge Kownator, Hanna Szwed, Iveta Mintale, Zoran Olivari, Harald Rittger, Evgeny V Shlyakhto, Rimvydas Slapikas, Philippe Gabriel Steg, Marco Valgimigli, Eric Van Belle, Konstantinos Tsioufis, Wojciech Majda, Cécile Laroche, Aldo P Maggioni
Aim Chronic ischaemic cardiovascular disease (CICD) remains a leading cause of morbidity and mortality worldwide. The CICD Pilot Registry enrolled 2420 patients across 10 European Society of Cardiology countries prospectively to describe characteristics, management strategies and clinical outcomes in this setting. We report here the six-month outcomes. Methods and results From the overall population, 2203 patients were analysed at six months. Fifty-eight patients (2.6%) died after inclusion; 522 patients (23...
January 1, 2018: European Journal of Preventive Cardiology
Ioanna Sokoreli, Steffen C Pauws, Ewout W Steyerberg, Gert-Jan de Vries, Jarno M Riistama, Aleksandra Tesanovic, Syed Kazmi, Pierpaolo Pellicori, John G Cleland, Andrew L Clark
AIMS: Psychosocial factors are rarely collected in studies investigating the prognosis of patients with heart failure (HF), and only time to first event is commonly reported. We investigated the prognostic value of psychosocial factors for predicting first or recurrent events after discharge following hospitalization for HF. METHODS AND RESULTS: OPERA-HF is an observational study enrolling patients hospitalized for HF. In addition to clinical variables, psychosocial variables are recorded...
January 4, 2018: European Journal of Heart Failure
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