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https://www.readbyqxmd.com/read/29134928/potential-link-between-post-acute-ischemic-stroke-exposure-to-hypoglycemia-and-hemorrhagic-transformation
#1
Kyle D Klingbeil, Sebastian Koch, Kunjan R Dave
Hemorrhagic transformation is a severe complication of acute ischemic stroke owing to its limited treatment options and poor prognosis. In the last decade, the rates of hemorrhagic transformation incidence have been associated with blood glucose levels. In particular, hyperglycemia at the time of admission has been associated with increased rates of hemorrhagic transformation in acute ischemic stroke patients. Recent pilot clinical trials have attempted to use intensive insulin therapy during stroke treatment to reduce the severity of cerebral infarction and possibly alleviate the risk of hemorrhagic transformation...
January 1, 2017: International Journal of Stroke: Official Journal of the International Stroke Society
https://www.readbyqxmd.com/read/29132152/diagnostic-accuracy-of-screening-tests-and-treatment-for-post-acute-coronary-syndrome-depression-a-systematic-review
#2
Jason A Nieuwsma, John W Williams, Natasha Namdari, Jeffrey B Washam, Giselle Raitz, James A Blumenthal, Wei Jiang, Roshini Yapa, Amanda J McBroom, Kathryn Lallinger, Robyn Schmidt, Andrzej S Kosinski, Gillian D Sanders
Background: Patients who have had an acute coronary syndrome (ACS) event have an increased risk for depression. Purpose: To evaluate the diagnostic accuracy of depression screening instruments and to compare safety and effectiveness of depression treatments in adults within 3 months of an ACS event. Data Sources: MEDLINE, EMBASE, PsycINFO, CINAHL, and Cochrane Database of Systematic Reviews from January 2003 to August 2017, and a manual search of citations from key primary and review articles...
November 14, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/29131132/points-of-concern-in-post-acute-kidney-injury-management
#3
Jill Vanmassenhove, Raymond Vanholder, Norbert Lameire
The incidence of acute kidney injury (AKI) will in the future remain high, partly due to an increase in comorbidities and other AKI favoring factors such as the rise in high-risk diagnostic and therapeutic interventions. AKI has emerged as a major public health concern with high human and financial costs. It has recently been demonstrated that patients surviving an AKI episode show increased all-cause mortality, chronic kidney disease (CKD), ESRD, cardiovascular events, and reduced quality of life. Although it is important to acknowledge that, after an AKI episode, the risk of dying by far exceeds the risk of developing incident or progressive CKD and/or entering a maintenance renal replacement therapy (RRT) program, currently only a minority of patients are referred for renal follow-up, even after AKI-requiring RRT...
November 2, 2017: Nephron
https://www.readbyqxmd.com/read/29128648/a-hypertension-emergency-department-intervention-aimed-at-decreasing-disparities-design-of-a-randomized-clinical-trial
#4
Heather M Prendergast, Marina Del Rios, Renee Petzel-Gimbar, Daniel Garside, Sara Heinert, Sandra Escobar-Schulz, Pavitra Kotini-Shah, Michael Brown, Jinsong Chen, Joseph Colla, Marian Fitzgibbon, Ramon A Durazo-Arvizu, Martha Daviglus
Effective interventions to identify and treat uncontrolled hypertension (HTN), particularly in underrepresented populations that use the emergency department (ED) for primary care, are critically needed. Uncontrolled HTN contributes significantly to cardiovascular morbidity and mortality and is more frequently encountered among patients presenting to the ED as compared to the primary care setting. EDs serve as the point of entry into the health care system for high-risk patient populations, including minority and low-income patients...
November 8, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/29126112/risk-scoring-to-guide-anti-platelet-therapy-post-percutaneous-coronary-intervention-pci-for-acute-coronary-syndrome-acs-results-in-improved-clinical-outcomes
#5
S Antoniou, M Colicchia, O Guttmann, K Rathod, P Wright, S Fhadil, C Knight, A K Jain, E J Smith, A Mathur, R Weerackody, A Wragg, D A Jones
Objective: To use the GRACE and CRUSADE scores to risk stratify anti-platelet treatment post Acute Coronary Syndrome (ACS). Methods: This was a prospective registry of 3374 patients undergoing PCI for ACS between 2013-2015 at a UK cardiac centre. Patients with either low GRACE or high CRUSADE risk scores were stratified to clopidogrel therapy otherwise ticagrelor was used. The primary end-point was major adverse cardiac events (MACE) defined as death, non-fatal myocardial infarction, stroke, or target vessel revascularization with bleeding rates as a secondary outcome, assessed at a median follow-up of 1...
November 8, 2017: European Heart Journal. Quality of Care & Clinical Outcomes
https://www.readbyqxmd.com/read/29107492/is-rapid-recovery-hip-and-knee-replacements-possible-and-safe-in-the-octogenarian-patient
#6
Paul K Edwards, James R Kee, Simon C Mears, C Lowry Barnes
BACKGROUND: Rapid recovery programs are now aimed to reduce costs of hip and knee arthroplasties by discharging patients directly home, shortening hospital length of stay (LOS), and reducing readmission rates. Although patients aged 80 years and older are included in the Medicare bundle, little work has been performed to determine if older patients can safely participate in rapid recovery programs. METHODS: We retrospectively reviewed 2482 patients undergoing primary and revision total hip and knee arthroplasties (THA and TKA) who all participated in a multifaceted rapid recovery program...
October 6, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29106679/toward-a-common-language-for-measuring-patient-mobility-in-the-hospital-reliability-and-construct-validity-of-interprofessional-mobility-measures
#7
Erik H Hoyer, Daniel L Young, Lisa M Klein, Julie Kreif, Kara Shumock, Stephanie Hiser, Michael Friedman, Annette Lavezza, Alan Jette, Kitty S Chan, Dale M Needham
Background: The lack of common language among interprofessional inpatient clinical teams is an important barrier to achieving inpatient mobilization. In The Johns Hopkins Hospital, the Activity Measure for Post-Acute Care (AM-PAC) Inpatient Mobility Short Form (IMSF), also called "6-Clicks,"and the Johns Hopkins Highest Level of Mobility (JH-HLM) are part of routine clinical practice. The measurement characteristics of these tools when used by both nurses and physical therapists for interprofessional communication or assessment are unknown...
November 2, 2017: Physical Therapy
https://www.readbyqxmd.com/read/29105897/chronic-intensive-care-related-pain-exploratory-analysis-on-predictors-and-influence-on-health-related-quality-of-life
#8
P Baumbach, T Götz, A Günther, T Weiss, W Meissner
BACKGROUND: There is growing evidence for the development of chronic pain after intensive care. Nonetheless, there is only limited knowledge about factors leading to chronic intensive care-related pain (CIRP). Thus, the primary objective was the identification of predictors of CIRP. Moreover, we aimed to assess the impact of CIRP on patients' health-related quality of Life (HRQOL). METHODS: Comprehensive information on patients' pain before ICU admission and present pain was collected longitudinally by means of the German Pain Questionnaire 6 and 12 months after ICU discharge (ICUDC )...
November 5, 2017: European Journal of Pain: EJP
https://www.readbyqxmd.com/read/29094480/myocardial-infarction-does-not-affect-circulating-hematopoietic-stem-and-progenitor-cell-self-renewal-ability-in-a-rat-model
#9
J M Kröpfl, C M Spengler, A Frobert, G Ajalbert, M N Giraud
Due to the importance of peripheral blood hematopoietic stem and progenitor cells (HPCs) in post-acute regeneration after acute myocardial infarction (MI), the present study aimed to investigate count and secondary replating capacity/self-renewal ability of HPCs in peripheral blood before and two weeks after MI. In nine female Lewis inbred rats (n = 9), myocardial infarction was induced by ligation of the left coronary artery while another nine had surgery without ligation for control purposes. Myocardial infarction was confirmed by troponin I concentrations 24 h after MI...
November 2, 2017: Experimental Physiology
https://www.readbyqxmd.com/read/29089456/no-racial-difference-in-rehabilitation-therapy-across-all-post-acute-care-settings-in-the-year-following-a-stroke
#10
Lesli E Skolarus, Chunyang Feng, James F Burke
BACKGROUND AND PURPOSE: Black stroke survivors experience greater poststroke disability than whites. Differences in post-acute rehabilitation may contribute to this disparity. Therefore, we estimated racial differences in rehabilitation therapy utilization, intensity, and the number of post-acute care settings in the first year after a stroke. METHODS: We used national Medicare data to study 186 168 elderly black and white patients hospitalized with a primary diagnosis of stroke in 2011...
October 31, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29077945/minimally-clinically-important-change-in-the-activity-measure-for-post-acute-care-am-pac-a-generic-patient-reported-outcome-tool-in-people-with-low-back-pain
#11
Natalie Lee, Nicolas R Thompson, Sandra Passek, Mary Stilphen, Irene L Katzan
Background: The Activity Measure for Post-Acute Care (AM-PAC) is a generic metric of patient-reported functional status. The minimal clinically important difference (MCID) in the AM-PAC score has not been determined. Objective: The study objective was to determine the MCID for AM-PAC in people with low back pain. Design: This was a retrospective cohort study. Methods: Anchor-based and distribution-based methods were used to estimate the MCID...
November 1, 2017: Physical Therapy
https://www.readbyqxmd.com/read/29066878/acute-exacerbated-copd-room-for-improvement-in-key-elements-of-care
#12
Stefan Markun, Daniel P Franzen, Kaba Dalla Lana, Swantje Beyer, Stephan Wieser, Thomas Hess, Malcolm Kohler, Thomas Rosemann, Oliver Senn, Claudia Steurer-Stey
INTRODUCTION: Hospitalizations because of acute exacerbated COPD (AECOPD) are a major burden to patients and the health care system. Interventions during acute and post-acute hospital care exist not only to improve short-term outcomes but also to prevent future exacerbations and disease progression. We aimed at measuring the implementation rates of acute and post-acute hospital care interventions for AECOPD. METHODS: We performed 24 months (January 1, 2012, to December 31, 2013) retrospective medical chart review of consecutive cases hospitalized to one of three public hospitals in the canton of Zurich due to AECOPD...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/29066584/predicting-30-day-all-cause-readmission-risk-for-subjects-admitted-with-pneumonia-at-the-point-of-care
#13
Umur Hatipoğlu, Brian J Wells, Kevin Chagin, Dhruv Joshi, Alex Milinovich, Michael B Rothberg
BACKGROUND: The pneumonia 30-d readmission rate has been endorsed by the National Quality Forum as a quality metric. Hospital readmissions can potentially be lowered by improving in-hospital care, transitions of care, and post-discharge disease management programs. The purpose of this study was to create an accurate prediction model for determining the risk of 30-d readmission at the point of discharge. METHODS: The model was created using a data set of 1,295 hospitalizations at the Cleveland Clinic Main Campus with pneumonia over 3 y...
October 24, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29066443/advanced-age-and-post-acute-care-outcomes-after-subarachnoid-hemorrhage
#14
Corey R Fehnel, William B Gormley, Hormuzdiyar Dasenbrock, Yoojin Lee, Faith Robertson, Alexandra G Ellis, Vincent Mor, Susan L Mitchell
BACKGROUND: Older patients with aneurysmal subarachnoid hemorrhage (aSAH) are unique, and determinants of post-acute care outcomes are not well elucidated. The primary objective was to identify hospital characteristics associated with 30-day readmission and mortality rates after hospital discharge among older patients with aSAH. METHODS AND RESULTS: This cohort study used Medicare patients ≥65 years discharged from US hospitals from January 1, 2008, to November 30, 2010, after aSAH...
October 24, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29064733/a-novel-tool-for-naturalistic-assessment-of-behavioural-dysregulation-after-traumatic-brain-injury-a-pilot-study
#15
Ashlee McKeon, Lauren Terhorst, Elizabeth Skidmore, Dan Ding, Rory Cooper, Michael McCue
OBJECTIVE: This study aimed to develop a novel tool for measuring behavioural dysregulation in adults with traumatic brain injury (TBI) using objective data sources and real-world application and provide preliminary evidence for its psychometric properties. RESEARCH DESIGN: Fourteen adults with TBI receiving services at a local brain injury rehabilitation programme completed multiple assessments of behaviour and followed by a series of challenging problem-solving tasks while being video recorded...
October 24, 2017: Brain Injury: [BI]
https://www.readbyqxmd.com/read/29061633/factors-associated-with-quality-of-life-in-elderly-hospitalised-patients-undergoing-post-acute-rehabilitation-a-cross-sectional-analytical-study-in-switzerland
#16
Marc-Antoine Bornet, Eve Rubli Truchard, Etienne Rochat, Jérôme Pasquier, Stéfanie Monod
OBJECTIVES: We investigated whether biopsychosocial and spiritual factors and satisfaction with care were associated with patients' perceived quality of life. DESIGN: This was a cross-sectional analytical study. SETTING: Data were collected from inpatients at a postacute geriatric rehabilitation centre in a university hospital in Switzerland. PARTICIPANTS: Participants aged 65 years and over were consecutively recruited from October 2014 to January 2016...
October 22, 2017: BMJ Open
https://www.readbyqxmd.com/read/29061146/health-related-quality-of-life-in-persons-with-west-nile-virus-infection-a-longitudinal-cohort-study
#17
Man Wah Yeung, George Tomlinson, Mark Loeb, Beate Sander
BACKGROUND: West Nile virus (WNV) infections are predominantly asymptomatic, although almost 1% become neuroinvasive and debilitating. We describe the impact of neuroinvasive and non-neuroinvasive disease on patient health-related quality of life (HRQoL). METHODS: Short Form 36 questionnaire data came from a Canadian WNV cohort (Loeb 2008) of 154 patients followed for up to three years. We generated health utilities using the SF-6D. We calculated mean utility scores throughout follow-up and examined predictors using a linear mixed-effects model...
October 23, 2017: Health and Quality of Life Outcomes
https://www.readbyqxmd.com/read/29055633/colchicine-therapy-and-plaque-stabilization-in-patients-with-acute%C3%A2-coronary-syndrome-a-ct-coronary-angiography-study
#18
Kaivan Vaidya, Clare Arnott, Gonzalo J Martínez, Bernard Ng, Samuel McCormack, David R Sullivan, David S Celermajer, Sanjay Patel
OBJECTIVES: The authors sought to evaluate the plaque-modifying effects of low-dose colchicine therapy plus optimal medical therapy (OMT) in patients post-acute coronary syndrome (ACS), as assessed by coronary computed tomography angiography (coronary CTA). BACKGROUND: Colchicine therapy has been postulated to have beneficial anti-inflammatory effects in patients with ACS, translating into reduction in future adverse cardiovascular events. However, whether favorable plaque modification underpins this is yet unproven...
October 14, 2017: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29051001/episode-based-payment-variation-for-urological-cancer-surgery
#19
Chad Ellimoottil, Jonathan Li, Zaojun Ye, James M Dupree, Hye Sung Min, Deborah Kaye, Lindsey A Herrel, David C Miller
OBJECTIVE: To investigate payment variation for three common urological cancer surgeries and evaluate the potential for applying bundled payment programs to these procedures. METHODS: Using 2008-2011 Surveillance, Epidemiology, and End Results-Medicare linked data, we identified all beneficiaries aged greater than 65 years who underwent cystectomy, prostatectomy, or nephrectomy for cancer. Total episode payments were determined by aggregating hospital, professional, and post-acute care claims from the index surgical hospitalization through 90 days post-discharge...
October 16, 2017: Urology
https://www.readbyqxmd.com/read/29043654/evaluation-of-selected-micrornas-expression-in-remission-phase-of-multiple-sclerosis-and-their-potential-link-to-cognition-depression-and-disability
#20
Marta Niwald, Monika Migdalska-Sęk, Ewa Brzeziańska-Lasota, Elżbieta Miller
Accumulating data suggests that miRNAs might play a major role in neuroinflammatory processes. Therefore, our study aimed to first estimate the levels of miR-155, miR-326, and miR-301a in serum of RR-MS patients in the remission phase and then compare the levels of the examined miRNAs at different times after relapse. In this study, 36 RR-MS patients in the remission phase took part. We analyzed two subgroups of RR-MS: one, 1 to 2 months after completing steroid treatment during relapse (post-acute; n = 13) and the other, over 2 years without any relapse (stable; n = 23)...
October 17, 2017: Journal of Molecular Neuroscience: MN
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