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https://www.readbyqxmd.com/read/27919450/development-and-validation-of-a-prediction-model-for-patients-discharged-to-post-acute-care-after-colorectal-cancer-surgery
#1
Elizabeth A Bailey, Rebecca L Hoffman, Christopher Wirtalla, Giorgos Karakousis, Rachel R Kelz
BACKGROUND: As payment shifts toward bundled reimbursement, decreasing unnecessary inpatient care may provide cost savings. This study examines the association between discharge status, hospital duration of stay, and cost for colorectal operation patients without complications and uses risk factors to predict the need for post-acute care. METHODS: We used the New York Statewide Planning and Research Cooperative System and the California Healthcare Cost and Utilization Project State Inpatient Databases to identify all patients who underwent operative resection for colorectal cancer in 2009-2010 and were discharged to home or post-acute care...
December 2, 2016: Surgery
https://www.readbyqxmd.com/read/27915044/a-novel-aldosterone-synthase-inhibitor-ameliorates-mortality-in-pressure-overload-mice-with-heart-failure
#2
Shinji Furuzono, Masaki Meguro, Satoru Miyauchi, Shinichi Inoue, Tsuyoshi Homma, Keisuke Yamada, Yoh-Ichi Tagawa, Futoshi Nara, Takahiro Nagayama
It has been elucidated that mineralocorticoid receptor antagonists reduce mortality in patients with congestive heart failure and post-acute myocardial infarction. A direct inhibition of aldosterone synthase (CYP11B2) is also expected to have therapeutic benefits equal in quality to mineralocorticoid receptor antagonists in terms of reducing mineralocorticoid receptor signaling. Therefore, we have screened our chemical libraries and identified a novel and potent aldosterone synthase inhibitor, 2,2,2-trifluoro-1-{4-[(4-fluorophenyl)amino]pyrimidin-5-y}-1-[1-(methylsulfonyl)piperidin-4-yl]ethanol (compound 1), by lead optimization...
November 30, 2016: European Journal of Pharmacology
https://www.readbyqxmd.com/read/27914968/segmenting-high-cost-medicare-patients-into-potentially-actionable-cohorts
#3
Karen E Joynt, Jose F Figueroa, Nancy Beaulieu, Robert C Wild, E John Orav, Ashish K Jha
BACKGROUND: Providers are assuming growing responsibility for healthcare spending, and prior studies have shown that spending is concentrated in a small proportion of patients. Using simple methods to segment these patients into clinically meaningful subgroups may be a useful and accessible strategy for targeting interventions to control costs. METHODS: Using Medicare fee-for-service claims from 2011 (baseline year, used to determine comorbidities and subgroups) and 2012 (spending year), we used basic demographics and comorbidities to group beneficiaries into 6 cohorts, defined by expert opinion and consultation: under-65 disabled/ESRD, frail elderly, major complex chronic, minor complex chronic, simple chronic, and relatively healthy...
November 30, 2016: Healthcare
https://www.readbyqxmd.com/read/27914504/on-treatment-analysis-of-the-improved-reduction-of-outcomes-vytorin-efficacy-international-trial-improve-it
#4
Michael A Blazing, Robert P Giugliano, James A de Lemos, Christopher P Cannon, Andrew Tonkin, Christie M Ballantyne, Basil S Lewis, Thomas A Musliner, Andrew M Tershakovec, Yuliya Lokhnygina, Jennifer A White, Craig Reist, Amy McCagg, Eugene Braunwald
BACKGROUND: We aimed to determine the efficacy and safety of adding ezetimibe (Ez) to simvastatin (S) in a post-acute coronary syndrome (ACS) population in a prespecified on-treatment analysis. METHODS: We evaluated 17,706 post-ACS patients from the IMPROVE-IT trial who had low-density lipoprotein cholesterol values between 50 and 125 mg/dL and who received Ez 10 mg/d with S 40 mg/d (Ez/S) or placebo with simvastatin 40 mg/d (P/S). The primary composite end point was cardiovascular death, myocardial infarction, unstable angina, coronary revascularization ≥30 days postrandomization, or stroke...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27913007/higher-post-acute-myocardial-infarction-plasma-haptoglobin-level-is-associated-with-poor-long-term-overall-survival
#5
Kuang-Hsing Chiang, Yung-Ta Kao, Hsin-Bang Leu, Po-Hsun Huang, Shao-Sung Huang, Tsai-Mu Cheng, Ju-Pin Pan
AIM: To evaluate the association of post-acute myocardial infarction (AMI) plasma haptoglobin (Hp) levels with long-term overall survival in AMI patients. METHODS AND RESULTS: Patients who were diagnosed of AMI were recruited and their Hp phenotypes and plasma levels were determined. According to previously reported cutoff point for Hp level (288.4ng/ml), patients were classified as higher Hp group (>288.4ng/ml) and lower Hp group (≤288.4ng/ml). The primary outcome was overall survival...
November 10, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27911071/severe-brain-injury-in-massachusetts-assessing-the-continuum-of-care
#6
Laura Lorenz, Gabrielle Katz
Acquired brain injury (ABI) is a major public health problem in Massachusetts (Hackman et al, 2014) and includes traumatic brain injury (TBI), stroke, ABI-related infectious diseases, metabolic disorders affecting the central nervous system (brain and spinal cord), and brain tumor. Advances in emergency medical care and neurosurgery mean that more people are surviving severe traumatic brain injury (Trexler et al, 2014). Yet many patients with severe TBI in particular, are not receiving inpatient services after initial treatment (Hackman et al, 2014; CDC, 2014) or later that are known to be effective (Malec & Kean, 2015; Lewis & Horn, 2015; BI Commission, 2011; Kolakowsky-Hayner et al, 2000; Interviews)...
December 10, 2015: Issue Brief
https://www.readbyqxmd.com/read/27906914/the-impact-of-a-surgical-assessment-unit-on-numbers-of-general-surgery-outliers
#7
Alexandra Jacobson, Garth Poole, Andrew G Hill, Magdalena Biggar
AIMS: Patient care and efficiency outcomes are improved if acute patients admitted to non-specialty (outlier) wards are minimised.1 Assessment units may help to reduce numbers of outlier patients.2 A surgical assessment unit (SAU) was recently established at Middlemore Hospital. We aimed to determine the impact of its introduction on numbers of general surgery outliers on post-acute ward rounds. METHODS: A 10-bed SAU was introduced in July 2015, coinciding with the closure of 20 beds on the general surgical wards...
December 2, 2016: New Zealand Medical Journal
https://www.readbyqxmd.com/read/27902744/delirium-detection-and-impact-of-comorbid-health-conditions-in-a-post-acute-rehabilitation-hospital-setting
#8
Julija Stelmokas, Nicolette Gabel, Jennifer M Flaherty, Katherine Rayson, Kathileen Tran, Jason R Anderson, Linas A Bieliauskas
Misdiagnosis and under-detection of delirium may occur in many medical settings. This is important to address as delirium clearly increases risk of morbidity and mortality in such settings. This study assessed whether Veterans who screened positive on a delirium severity measure (Memorial Delirium Assessment Scale; MDAS) differed from those with and without corresponding medical documentation of delirium in terms of cognitive functioning, psychiatric/medical history, and medication use. A medical record review of 266 inpatients at a VA post-acute rehabilitation unit found that 10...
2016: PloS One
https://www.readbyqxmd.com/read/27902532/lean-six-sigma-to-reduce-intensive-care-unit-length-of-stay-and-costs-in-prolonged-mechanical-ventilation
#9
Stephen Trzeciak, Michael Mercincavage, Cory Angelini, William Cogliano, Emily Damuth, Brian W Roberts, Sergio Zanotti, Anthony J Mazzarelli
OBJECTIVE: Patients with prolonged mechanical ventilation (PMV) represent important "outliers" of hospital length of stay (LOS) and costs (∼$26 billion annually in the United States). We tested the hypothesis that a Lean Six Sigma (LSS) approach for process improvement could reduce hospital LOS and the associated costs of care for patients with PMV. DESIGN: Before-and-after cohort study. SETTING: Multidisciplinary intensive care unit (ICU) in an academic medical center...
November 29, 2016: Journal for Healthcare Quality: Official Publication of the National Association for Healthcare Quality
https://www.readbyqxmd.com/read/27902344/pre-infection-transcript-levels-of-fam26f-in-pbmcs-inform-about-overall-plasma-viral-load-in-acute-and-postacute-phase-after-siv-infection
#10
Aneela Javed, Nicole Leuchte, Gabriela Salinas, Lennart Opitz, Christiane Stahl-Hennig, Sieghart Sopper, Ulrike Sauermann
CD8+ cells from simian immunodeficiency virus (SIV)-infected long-term non-progressors and some uninfected macaques can suppress viral replication in vitro without killing the infected cells. The aim of the study was to identify factors responsible for non-cytolytic viral suppression by transcriptional profiling and to investigate their potential impact on SIV-replication. Results of microarray experiments and further validation with cells from infected and uninfected macaques revealed that FAM26F RNA levels distinguished CD8+ cells of controllers and non-controllers (p=0...
October 18, 2016: Journal of General Virology
https://www.readbyqxmd.com/read/27890332/impact-of-hospital-transfer-on-surgical-outcomes-of-intestinal-atresia
#11
T Erickson, P G Vana, B A Blanco, S A Brownlee, H N Paddock, P C Kuo, A N Kothari
BACKGROUND: Examine effects of hospital transfer into a quaternary care center on surgical outcomes of intestinal atresia. METHODS: Children <1 yo principally diagnosed with intestinal atresia were identified using the Kids' Inpatient Database (2012). Exposure variable was patient transfer status. Outcomes measured were inpatient mortality, hospital length of stay (LOS) and discharge status. Linearized standard errors, design-based F tests, and multivariable logistic regression were performed...
November 12, 2016: American Journal of Surgery
https://www.readbyqxmd.com/read/27885060/gender-differences-in-physical-activity-following-acute-myocardial-infarction-in-adults-a-prospective-observational-study
#12
Karl E Minges, Kelly M Strait, Neville Owen, David W Dunstan, Sarah M Camhi, Judith Lichtman, Mary Geda, Rachel P Dreyer, Héctor Bueno, John F Beltrame, Jeptha P Curtis, Harlan M Krumholz
AIMS: Despite the benefits of regular physical activity participation following acute myocardial infarction, little is known about gender differences in physical activity among patients after acute myocardial infarction. We described, by gender, physical activity trajectories pre- and post-acute myocardial infarction, and determined whether gender was independently associated with physical activity. METHODS AND RESULTS: The Variation in Recovery: Role of Gender on Outcomes of Young AMI patients (VIRGO) study, conducted at 103 US, 24 Spanish, and three Australian hospitals, was designed, in part, to evaluate gender differences in lifestyle behaviors following acute myocardial infarction...
November 24, 2016: European Journal of Preventive Cardiology
https://www.readbyqxmd.com/read/27882909/european-initiative-for-the-application-of-the-international-classification-of-functioning-disability-and-health-development-of-clinical-assessment-schedules-for-specified-rehabilitation-services
#13
Birgit Prodinger, Anke Scheel-Sailer, Reuben Escorpizo, Gerold Stucki
BACKGROUND: Clinical assessment schedule (CLAS) is a core part of the ICF-based implementation of functioning reporting across health conditions and along the continuum of care. AIM: The Physical and Rehabilitation Medicine Section and Board of the European Union of Medical Specialists (UEMS PRM) workshop held in January 2016 aimed to develop and specify a CLAS within the context of rehabilitation services. SETTING: UEMS PRM Workshop in Nottwil, Switzerland, January 2016...
November 24, 2016: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27882908/european-initiative-for-the-application-of-the-international-classification-of-service-organization-in-health-related-rehabilitation-icso-r
#14
Carlotte Kiekens, Thorsten Meyer, Francesca Gimigliano, Cristiana Baffone, Christoph M Gutenbrunner
BACKGROUND: The International Classification of Functioning, Disability and Health (ICF) should be used as the framework for the development of a clinical assessment schedule for clinical quality management of health-related rehabilitation services. For the description of rehabilitation services a working group of the ISPRM-WHO-Liaison Committee proposed an instrument called "International Classification System for Service Organization in Health-related Rehabilitation" or ICSO-R. AIM: To test the applicability and feasibility of ICSO-R to describe rehabilitation services and to propose further improvements...
November 24, 2016: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/27881152/fitness-and-mobility-training-in-patients-with-intensive-care-unit-acquired-muscle-weakness-fitonicu-study-protocol-for-a-randomised-controlled-trial
#15
Jan Mehrholz, Simone Thomas, Jane H Burridge, André Schmidt, Bettina Scheffler, Ralph Schellin, Stefan Rückriem, Daniel Meißner, Katja Mehrholz, Wolfgang Sauter, Ulf Bodechtel, Bernhard Elsner
BACKGROUND: Critical illness myopathy (CIM) and polyneuropathy (CIP) are a common complication of critical illness. Both cause intensive-care-unit-acquired (ICU-acquired) muscle weakness (ICUAW) which increases morbidity and delays rehabilitation and recovery of activities of daily living such as walking ability. Focused physical rehabilitation of people with ICUAW is, therefore, of great importance at both an individual and a societal level. A recent systematic Cochrane review found no randomised controlled trials (RCT), and thus no supporting evidence, for physical rehabilitation interventions for people with defined CIP and CIM to improve activities of daily living...
November 24, 2016: Trials
https://www.readbyqxmd.com/read/27873213/is-management-of-hyperglycaemia-in-acute-phase-stroke-still-a-dilemma
#16
REVIEW
C Savopoulos, G Kaiafa, I Kanellos, A Fountouki, D Theofanidis, A I Hatzitolios
INTRODUCTION: Close monitoring of blood glucose levels during the immediate post-acute stroke phase is of great clinical value, as there is evidence that the risk of neurological deterioration is associated with both hyper- and hypoglycaemia. The aim of this review paper is to summarise the evidence on post-stroke blood glucose management and its impact on clinical outcomes, during the early post-acute stage. FINDINGS: Post-stroke hyperglycaemia has been associated with increased cerebral oedema, haemorrhagic transformation, lower likelihood of recanalisation and deteriorating neurological state...
November 21, 2016: Journal of Endocrinological Investigation
https://www.readbyqxmd.com/read/27871218/the-validity-of-the-brain-injury-cognitive-screen-bics-as-a-neuropsychological-screening-assessment-for-traumatic-and-non-traumatic-brain-injury
#17
Frances L Vaughan, Jo Anne Neal, Farzana Nizam Mulla, Barbara Edwards, Rudi Coetzer
OBJECTIVE: The Brain Injury Cognitive Screen (BICS) was developed as an in-service cognitive assessment battery for acquired brain injury patients entering community rehabilitation. The BICS focuses on domains that are particularly compromised following TBI, and provides a broader and more detailed assessment of executive function, attention and information processing than comparable screening assessments. The BICS also includes brief assessments of perception, naming, and construction, which were predicted to be more sensitive to impairments following non-traumatic brain injury...
November 22, 2016: Clinical Neuropsychologist
https://www.readbyqxmd.com/read/27870676/bundled-payments-for-care-improvement-lessons-learned-in-the-first-year
#18
Peter L Althausen, Lisa Mead
The Bundled Payments for Care Improvement (BPCI) initiative is the latest cost-saving program developed by the Center for Medicare and Medicaid Innovation. This model is intended to create a system for higher quality and more coordinated care at a lower cost to Medicare. It is currently an optional program for physician groups, hospitals and post-acute care providers to benefit financially from improved care models and cost containment measures. Under the initiative, organizations enter into payment arrangements that include financial and performance accountability for episodes of care...
December 2016: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27869893/-anmco-position-paper-recommendations-for-the-follow-up-of-patients-with-pulmonary-thromboembolism
#19
Carlo D'Agostino, Pietro Zonzin, Iolanda Enea, Michele Massimo Gulizia, Walter Ageno, Piergiuseppe Agostoni, Michele Azzarito, Cecilia Becattini, Amedeo Bongarzoni, Francesca Bux, Franco Casazza, Nicoletta Corrieri, Michele D'Alto, Nicola D'Amato, Andrea Maria D'Armini, Maria Grazia De Natale, Giovanni Di Minno, Giuseppe Favretto, Lucia Filippi, Valentina Grazioli, Gualtiero Palareti, Raffaele Pesavento, Loris Roncon, Laura Scelsi, Antonella Tufano
Venous thromboembolism (VTE), including deep venous thrombosis and pulmonary embolism, is the third most common cause of cardiovascular death. The management of the acute phase of VTE is well described in several papers and guidelines, whereas the management of the follow-up of the patients affected from VTE is less defined. This position paper of the Italian Association of Hospital Cardiologists (ANMCO) tries to fill the gap using currently available evidence and the opinion of the experts to suggest the most useful way to manage patients in the chronic phase...
September 2016: Giornale Italiano di Cardiologia
https://www.readbyqxmd.com/read/27868384/post-acute-rehabilitation-after-total-knee-replacement-a-multicentre-randomized-clinical-trial-comparing-long-term-outcomes
#20
Marlene Fransen, Lillias Nairn, Lisa Bridgett, Jack Crosbie, Lyn March, David Parker Mbbs, Ross Crawford, Alison R Harmer
OBJECTIVE: To evaluate the long-term benefit of providing a post-acute outpatient group exercise program for patients following primary total knee replacement (TKR) surgery for osteoarthritis. METHODS: A multicenter randomized clinical trial conducted in 12 Australian public and private hospital centers. A total of 422 participants, aged 45 to 75 years, were randomly allocated prior to hospital discharge to the post-acute group exercise program or usual care and were assessed six weeks, six months and 12 months after surgery...
November 21, 2016: Arthritis Care & Research
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