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https://www.readbyqxmd.com/read/29785695/differences-in-characteristics-and-outcome-of-patients-with-penetrating-injuries-in-the-usa-and-the-netherlands-a-multi-institutional-comparison
#1
Suzan Dijkink, Pieta Krijnen, Aglaia Hage, Gwendolyn M Van der Wilden, George Kasotakis, Dennis den Hartog, Ali Salim, J Carel Goslings, Frank W Bloemers, Steven J Rhemrev, David R King, George C Velmahos, Inger B Schipper
INTRODUCTION: The incidence and nature of penetrating injuries differ between countries. The aim of this study was to analyze characteristics and clinical outcomes of patients with penetrating injuries treated at urban Level-1 trauma centers in the USA (USTC) and the Netherlands (NLTC). METHODS: In this retrospective cohort study, 1331 adult patients (470 from five NLTC and 861 from three USTC) with truncal penetrating injuries admitted between July 2011 and December 2014 were included...
May 21, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29785455/robotic-assisted-laparoscopic-median-arcuate-ligament-release-7-year-experience-from-a-single-tertiary-care-center
#2
Usah Khrucharoen, Yen-Yi Juo, Yas Sanaiha, Yijun Chen, Juan C Jimenez, Erik P Dutson
BACKGROUND: Despite previous reports of robotic-assisted laparoscopic release for median arcuate ligament syndrome (MALS), the safety and efficacy profile of this approach has been difficult to establish due to the rarity of this diagnostic entity. We aim to present our experience from a tertiary minimally invasive surgery referral center. METHODS: A case series was performed whereby all patients who underwent robotic-assisted MAL release from July 2010 to July 2017 at our institution were included...
May 21, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29785297/determination-of-the-intersegmental-plane-using-the-slip-knot-method
#3
Makoto Endoh, Hiroyuki Oizumi, Hirohisa Kato, Jun Suzuki, Hikaru Watarai, Akira Hamada, Katsuyuki Suzuki, Kenta Nakahashi, Mitsuaki Sadahiro
Background: Visualization of intersegmental planes in the lung is desirable for precise anatomical lung segmentectomy. We developed the slip-knot method for creating inflation-deflation lines. This study aimed to assess relevant data for thoracoscopic segmentectomy performed using this method. Methods: In the slip-knot method, the objective segmental bronchus is looped with a monofilament thread. One end of the thread is then pulled during temporary bilateral ventilation, causing the knot to slip toward the bronchus...
April 2018: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/29784219/an-attempt-to-stem-the-tide-exploring-the-effect-of-a-90-day-transitional-care-intervention-on-readmissions-to-an-acute-male-psychiatric-unit-in-south-africa
#4
Ulla A Botha, Marise Coetzee, Liezl Koen, Dana J H Niehaus
INTRODUCTION: Pressure on inpatient beds often results in premature discharges, which may precipitate early readmission. This has prompted an increased interest in transitional care interventions to bridge the gap between in- and outpatient care to reduce such readmissions. Our study aimed to assess the effect of a Transitional Care Service (TCS) on readmission rates in a high pressure inpatient service which utilizes a premature discharge policy to address bed pressures. METHODS: Sixty male patients identified for crisis discharge were offered a TCS for the first ninety days after discharge...
June 2018: Archives of Psychiatric Nursing
https://www.readbyqxmd.com/read/29783928/physical-activity-intervention-for-elderly-patients-with-reduced-physical-performance-after-acute-coronary-syndrome-hulk-study-rationale-and-design-of-a-randomized-clinical-trial
#5
Elisabetta Tonet, Elisa Maietti, Giorgio Chiaranda, Francesco Vitali, Matteo Serenelli, Giulia Bugani, Gianni Mazzoni, Rossella Ruggiero, Jonathan Myers, Giovanni Quinto Villani, Ursula Corvi, Giovanni Pasanisi, Simone Biscaglia, Rita Pavasini, Giulia Ricci Lucchi, Gianluigi Sella, Roberto Ferrari, Stefano Volpato, Gianluca Campo, Giovanni Grazzi
BACKGROUND: Reduced physical performance and impaired mobility are common in elderly patients after acute coronary syndrome (ACS) and they represent independent risk factors for disability, morbidity, hospital readmission and mortality. Regular physical exercise represents a means for improving functional capacity. Nevertheless, its clinical benefit has been less investigated in elderly patients in the early phase after ACS. The HULK trial aims to investigate the clinical benefit of an early, tailored low-cost physical activity intervention in comparison to standard of care in elderly ACS patients with reduced physical performance...
May 21, 2018: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/29783911/can-predictive-modeling-identify-head-and-neck-oncology-patients-at-risk-for-readmission
#6
Amy M Manning, Keith A Casper, Kay St Peter, Keith M Wilson, Jonathan R Mark, Ryan M Collar
Objective Unplanned readmission within 30 days is a contributor to health care costs in the United States. The use of predictive modeling during hospitalization to identify patients at risk for readmission offers a novel approach to quality improvement and cost reduction. Study Design Two-phase study including retrospective analysis of prospectively collected data followed by prospective longitudinal study. Setting Tertiary academic medical center. Subjects and Methods Prospectively collected data for patients undergoing surgical treatment for head and neck cancer from January 2013 to January 2015 were used to build predictive models for readmission within 30 days of discharge using logistic regression, classification and regression tree (CART) analysis, and random forests...
May 1, 2018: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/29783858/effectiveness-and-safety-comparison-for-systemic-corticosteroid-therapy-with-and-without-inhaled-corticosteroids-for-copd-exacerbation-management
#7
Jordan A Pearce, Dane L Shiltz, Qian Ding
BACKGROUND: Only 1 small, single-center study has evaluated the combination of systemic plus inhaled corticosteroid (ICS) routes for chronic obstructive pulmonary disease (COPD) exacerbation management. This study aims to further improve the existing quantity and quality of evidence regarding the utility for combination therapy in the management of COPD exacerbation. OBJECTIVES: To evaluate length of hospital stay, readmission rate, incidence of infection, and mortality in hospitalized patients who experience a COPD exacerbation and receive systemic corticosteroid therapy with or without concurrent ICS...
May 1, 2018: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/29783749/differential-impact-of-malnutrition-on-health-outcomes-among-indigenous-and-non-indigenous-adults-admitted-to-hospital-in-regional-australia-a-prospective-cohort-study
#8
Natasha Morris, Simon Stewart, Malcolm Riley, Graeme Maguire
The burden of malnutrition in Indigenous people is a major health priority and this study's aims are to understand health outcomes among Indigenous and non-Indigenous patients. This cohort study includes 608 medical inpatients in three regional hospitals. Participants were screened for malnutrition using the Subjective Global Assessment tool. Hospital length of stay, discharge destination, 30-day and six-month hospital readmission and survival were measured. Although no significant difference was observed between Indigenous participants who were malnourished or nourished ( p = 0...
May 19, 2018: Nutrients
https://www.readbyqxmd.com/read/29783031/a-unique-all-payer-rate-setting-system-controls-the-cost-but-not-the-racial-disparity-in-lower-extremity-revascularization-procedures
#9
Besma Nejim, Robert J Beaulieu, Husain Alshaikh, Mohammed Hamouda, Joseph Canner, Mahmoud B Malas
BACKGROUND: Patients with peripheral arterial disease (PAD) often have high comorbidity burden that may complicate post-interventional course and drive increased healthcare expenditures. Racial disparity had been observed in lower extremity revascularization (LER) patterns and outcomes. In 2014, Maryland adopted an all-payer rate setting system to limit the rising hospitalization costs. This resulted in an aggregate payment system in which hospital compensation takes place as an overall per capita expenditure for hospital services...
May 18, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29782625/use-of-rituximab-and-risk-of-re-hospitalization-for-children-with-neuromyelitis-optica-spectrum-disorder
#10
Sabrina Gmuca, Rui Xiao, Pamela F Weiss, Amy T Waldman, Jeffrey S Gerber
Background: Treatment algorithms for neuromyelitis optica spectrum disorder (NMOSD) vary, and sparse data exist regarding the impact of initial treatments on disease course. We aimed to determine whether administration of rituximab during first hospitalization reduces 1-year readmission rates. Methods: We conducted a retrospective cohort study of subjects with NMOSD using the Pediatric Health Information System database from 2005-2015. Subjects were ages 1 to 21 years who received glucocorticoids and an ICD-9-CM code indicating neuromyelitis optica (NMO) during first hospitalization...
April 2018: Multiple Sclerosis and Demyelinating Disorders
https://www.readbyqxmd.com/read/29781955/involvements-of-parents-in-the-care-of-preterm-infants-a-pilot-study-evaluating-a-family-centered-care-intervention-in-a-chinese-neonatal-icu
#11
Rong Zhang, Rui-Wena Huang, Xi-Ronga Gao, Xiao-Minga Peng, Li-Hui Zhu, Ramanathan Rangasamy, Jos M Latour
OBJECTIVES: To evaluate the effectiveness and safety of a family-centered care intervention in a Chinese neonatal ICU. DESIGN: Pilot study using a randomized controlled trial design to inform a main randomized controlled trial study. SETTING: Stand-alone tertiary children's hospital in China with a 60-bed neonatal ICU serving as a regional neonatal ICU center. PATIENTS: Premature infants (n = 61) and their parents (n = 110)...
May 17, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29781923/going-beyond-clinical-care-to-reduce-health-care-spending-findings-from-the-j-chip-community-based-population-health-management-program-evaluation
#12
Shannon M E Murphy, Douglas E Hough, Martha L Sylvia, Melissa Sherry, Linda J Dunbar, Raymond Zollinger, Regina Richardson, Scott A Berkowitz, Kevin D Frick
BACKGROUND: Addressing both clinical and nonclinical determinants of health is essential for improving population health outcomes. In 2012, the Johns Hopkins Community Health Partnership (J-CHiP) implemented innovative population health management programs across acute and community environments. The community-based program involved multidisciplinary teams [ie, physicians, care managers (CM), health behavior specialists (HBS), community health workers, neighborhood navigators] and collaboration with community-based organizations to address social determinants...
May 17, 2018: Medical Care
https://www.readbyqxmd.com/read/29781388/hospitalization-metrics-associated-with-hospital-level-variation-in-inferior-vena-cava-filter-utilization-for-patients-with-venous-thromboembolism-in-the-united-states-implications-for-quality-of-care
#13
Ming Chen, Amie Goodin, Hong Xiao, Qiong Han, Driss Raissi, Joshua Brown
Variation in the use of inferior vena cava filters (IVCFs) across hospitals has been observed, suggesting differences in quality of care. Hospitalization metrics associated with venous thromboembolism (VTE) patients have not been compared based on IVCF utilization rates using a national sample. We conducted a descriptive retrospective study using the Nationwide Readmissions Database (NRD) to delineate the variability of hospitalization metrics across the hospital quartiles of IVCF utilization for VTE patients...
May 1, 2018: Vascular Medicine
https://www.readbyqxmd.com/read/29781302/does-continuing-family-based-treatment-for-adolescent-anorexia-nervosa-improve-outcomes-in-those-not-remitted-after-20-sessions
#14
Andrew Wallis, Jane Miskovic-Wheatley, Sloane Madden, Colleen Alford, Paul Rhodes, Stephen Touyz
OBJECTIVE: Our aim was to investigate the benefit of ongoing family-based treatment (FBT) sessions for adolescent anorexia nervosa if remission criteria were not met at session 20. METHOD: Participants were 69 medically unstable adolescents with Diagnostic and Statistical Manual of Mental Disorders (4th ed; DSM-IV) anorexia nervosa from a randomized controlled trial investigating length of hospital admission prior to outpatient FBT. Participants were divided post hoc into those meeting remission criteria at session 20 ( n = 16), those that had not remitted but continued with FBT ( n = 39) and those who ceased FBT undertaking alternative treatments ( n = 14)...
May 1, 2018: Clinical Child Psychology and Psychiatry
https://www.readbyqxmd.com/read/29779912/how-often-do-we-perform-painful-and-stressful-procedures-in-the-paediatric-intensive-care-unit-a-prospective-observational-study
#15
Manuel A Baarslag, Sharan Jhingoer, Erwin Ista, Karel Allegaert, Dick Tibboel, Monique van Dijk
BACKGROUND: Adequate analgesia and sedation is crucial in critical care. There is little knowledge on the extent of painful and stressful procedures on children admitted to a paediatric intensive care unit (PICU) and its analgesic and/or sedative management. OBJECTIVE: The primary objective was to determine the number of painful and stressful procedures per patient per day in our PICU patients, including the numbers of attempts. A secondary objective was to map PICU nurses' perceptions of the painfulness of the included procedures...
May 17, 2018: Australian Critical Care: Official Journal of the Confederation of Australian Critical Care Nurses
https://www.readbyqxmd.com/read/29779908/fixation-of-lung-apex-in-spontaneous-pneumothorax-is-safe-and-efficient-in-decrease-recurrences
#16
Wendy Yang, Pei-Yeh Chang, Ai-Hua Yeh, Yung-Ching Ming, Jeng Chang Chen, Jin-Yao Lai
BACKGROUND: Video-assisted thoracoscopic bullectomy with pleurodesis is widely used to treat spontaneous pneumothorax. However, 1%-3% of patients experience postoperative complications that may require reoperation, such as bleeding or prolonged air leaks, and 3%-7% of patients require a repeat thoracoscopic bullectomy due to recurrence. Therefore, a modified procedure with improved outcomes is required. METHODS: Between January 1, 2011 and December 31, 2015, 196 patients with spontaneous pneumothorax underwent thoracoscopic bullectomy and pleurodesis with or without fixation of the lung apex to the chest wall...
May 3, 2018: Pediatrics and Neonatology
https://www.readbyqxmd.com/read/29779804/the-importance-of-serum-albumin-determination-method-to-classify-patients-based-on-nutritional-status
#17
M Duque Alcorta, P Chanca Alvarez, R Nuñez Cabetas, Mj Alcaide Martín, M Valero, C Gómez Candela
The global health community has recognized the role of food and nutrition in health maintenance and disease prevention. Undernutrition is an important problem in clinical circles but it is still not highly considered by specialists. It is well known the consequences of undernutrition on the immunological systems. Furthermore, the main consequences are an increase of morbidity-mortality rates, postoperative complications, length of stay and number of hospital early readmissions. These are all reasons to lead to increase health-care financial costs...
June 2018: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/29779783/readmission-to-the-intensive-care-unit-following-cardiac-surgery-a-derived-and-validated-risk-prediction-model-in-4-869-patients
#18
Rebekah Thomson, Nick Fletcher, Oswaldo Valencia, Vivek Sharma
OBJECTIVE: To derive and validate a clinical risk index that can predict readmission to the intensive care unit (ICU) after cardiac surgery. DESIGN: Retrospective nonrandomized study to determine the perioperative variables associated with risk of readmission to the ICU after cardiac surgery. SETTING: The study was carried out in a single university hospital. PARTICIPANTS: This was an analysis of 4,869 consecutive adult patients...
April 18, 2018: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29779677/distinguishing-fecal-appendicular-peritonitis-from-purulent-appendicular-peritonitis
#19
M Mariage, C Sabbagh, T Yzet, H Dupont, A NTouba, J M Regimbeau
INTRODUCTION: Fecal appendicular peritonitis (FAP) is a poorly studied, rare form of acute appendicitis, corresponding to peritoneal inflammation with the presence of feces secondary to ruptured appendix. The purpose of this study was to describe FAP and to compare FAP with purulent appendicular peritonitis (PAP). PATIENTS AND METHODS: This single-center, retrospective study was conducted in consecutive patients to compare the FAP group and the PAP group. The primary endpoint was the 30-day postoperative morbidity and mortality according to the Clavien-Dindo classification...
April 9, 2018: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29779588/meta-analysis-comparing-transcatheter-and-surgical-treatments-of-paravalvular-leaks
#20
Tatiana Busu, Fahad Alqahtani, Vinay Badhwar, Chris C Cook, Charanjit S Rihal, Mohamad Alkhouli
Percutaneous paravalvular leak (PVL) closure has emerged as a feasible alternative to redo valve surgery. However, comparative data on percutaneous and surgical treatment of PVL are scarce. We performed a systematic review and a meta-analysis of studies on percutaneous and surgical treatments of PVL. Of the 2,267 studies screened, 22 eligible studies were analyzed. Primary end points were technical success, 30-day mortality, stroke, and length of stay. Secondary end points were 1-year mortality, readmission for heart failure, reoperation, and symptomatic improvement at follow-up...
April 20, 2018: American Journal of Cardiology
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