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https://www.readbyqxmd.com/read/28551445/decreasing-post-operative-narcotics-in-reconstructive-pelvic-surgery-a-randomized-controlled-trial
#1
Krista Ml Reagan, David M O'Sullivan, Richard Gannon, Adam C Steinberg
BACKGROUND: Post-operative pain control is crucial to any successful recovery plan. Many currently used medication regimens are narcotic-focused. OBJECTIVE: The objective of our study was to evaluate the efficacy of a multi-modal pain regimen after pelvic reconstructive surgery. STUDY DESIGN: The primary outcome measure was narcotic use. Secondary outcomes included pain, nausea and constipation. Patients were randomized to either a "usual care" post-operative treatment regimen or a multimodal pain regimen...
May 24, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28551089/prognosis-at-6-and-12months-after-self-attempted-hanging
#2
Guillaume Gantois, Erika Parmentier-Decrucq, Thibault Duburcq, Raphaël Favory, Daniel Mathieu, Julien Poissy
INTRODUCTION: Patients surviving a self-attempted hanging have a total neurological recovery in 57-77% of cases at hospital discharge, but no long-term data are available. METHODS: In this observational study, all patients hospitalized post-self-attempted hanging in the intensive care unit (ICU) in a 5-year period were included. Neurological evaluations at 6 and 12months were performed according to Cerebral Performance Category (CPC) scores. Factors associated with neurological recovery were determined by comparing CPC2+3+4 (bad recovery) vs...
May 23, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28550999/process-mining-routinely-collected-electronic-health-records-to-define-real-life-clinical-pathways-during-chemotherapy
#3
Karl Baker, Elaine Dunwoodie, Richard G Jones, Alex Newsham, Owen Johnson, Christopher P Price, Jane Wolstenholme, Jose Leal, Patrick McGinley, Chris Twelves, Geoff Hall
BACKGROUND: There is growing interest in the use of routinely collected electronic health records to enhance service delivery and facilitate clinical research. It should be possible to detect and measure patterns of care and use the data to monitor improvements but there are methodological and data quality challenges. Driven by the desire to model the impact of a patient self-test blood count monitoring service in patients on chemotherapy, we aimed to (i) establish reproducible methods of process-mining electronic health records, (ii) use the outputs derived to define and quantify patient pathways during chemotherapy, and (iii) to gather robust data which is structured to be able to inform a cost-effectiveness decision model of home monitoring of neutropenic status during chemotherapy...
July 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/28550896/pediatric-near-drowning-events-do-they-warrant-trauma-team-activation
#4
Pranit N Chotai, Lisa Manning, Benjamin Eithun, Joshua C Ross, James W Eubanks, Chad Hamner, Ankush Gosain
BACKGROUND: The purpose of this study was to determine the incidence of traumatic injuries, factors associated with mortality, and need for pediatric trauma surgery involvement for drowning and near-drowning events in children. MATERIALS AND METHODS: An institutional review board-approved, retrospective chart review was performed at three American College of Surgeons-verified Pediatric Trauma Centers (2011-2014). Patients with International Classification of Diseases, Ninth Revision, codes or E-codes for fatal-nonfatal drowning, fall into water, accidental drowning, or submersion were included...
May 15, 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28550699/the-poet-prevention-of-error-based-transfers-project
#5
Jill Oliver, Paula Chidwick
The PoET (Prevention of Error-based Transfers) Project is one of the Ethics Quality Improvement Projects (EQIPs) taking place at William Osler Health System. This specific project is designed to reduce transfers from long-term care to hospital that are caused by legal and ethical errors related to consent, capacity and substitute decision-making. The project is currently operating in eight long-term care homes in the Central West Local Health Integration Network and has seen a 56% reduction in multiple transfers before death in hospital...
2017: Healthcare Quarterly
https://www.readbyqxmd.com/read/28550459/patterns-of-drug-prescriptions-in-an-orthogeriatric-ward-as-compared-to-orthopaedic-ward-results-from-the-trondheim-hip-fracture-trial-a-randomised-clinical-trial
#6
Marianne Heltne, Ingvild Saltvedt, Stian Lydersen, Anders Prestmo, Olav Sletvold, Olav Spigset
PURPOSE: In the Trondheim Hip Fracture Trial, 397 home-dwelling patients with hip fractures were randomised to comprehensive geriatric care (CGC) in a geriatric ward or traditional orthopaedic care (OC). Patients in the CGC group had significantly better mobility and function 4 months after discharge. This study explores group differences in drug prescribing and possible associations with the outcomes in the main study. METHODS: Drugs prescribed at admission and discharge were registered from hospital records...
May 26, 2017: European Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28550430/robotic-transabdominal-cerclage-a-case-series-illustrating-costs
#7
Rebecca Lee, David Biats, Melissa Mancuso
The incidence of cervical insufficiency is 0.1-1% of all pregnancies and 8% of second trimester losses. After failed vaginal cerclages or in patients with amputated or congenitally abnormal cervices, transabdominal cerclages may be performed. Recent advances allow for use of the da Vinci robot to perform transabdominal cerclages. This case series presents three cases of robotically placed cerclages, performed prior to pregnancy. All patients had experienced prior second trimester losses. Two of the three had previously failed vaginal cerclage placement...
May 26, 2017: Journal of Robotic Surgery
https://www.readbyqxmd.com/read/28549765/improving-patient-centered-transitional-care-after-complex-abdominal-surgery
#8
Alexandra W Acher, Stephanie A Campbell-Flohr, Maria Brenny-Fitzpatrick, Kristine M Leahy-Gross, Sara Fernandes-Taylor, Alexander V Fisher, Suresh Agarwal, Amy J Kind, Caprice C Greenberg, Pascale Carayon, Sharon M Weber
BACKGROUND: Poor-quality transitions of care from hospital to home contribute to high rates of readmission after complex abdominal surgery. The Coordinated Transitional Care (C-TraC) program improved readmission rates in medical patients, but evidence-based surgical transitional care protocols are lacking. This pilot study evaluated the feasibility and preliminary effectiveness of an adapted surgical C-TraC protocol. STUDY DESIGN: The intervention includes in-person enrollment of patients...
May 18, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28545656/cord-plasma-insulin-and-in-utero-exposure-to-ambient-air-pollution
#9
Narjes Madhloum, Bram G Janssen, Dries S Martens, Nelly D Saenen, Esmée Bijnens, Wilfried Gyselaers, Joris Penders, Charlotte Vanpoucke, Wouter Lefebvre, Michelle Plusquin, Tim S Nawrot
INTRODUCTION: Cardio-metabolic risk factors including insulin levels are at young age barely perceived as harmful, but over time these risk factors may track and lead to higher risk of metabolic syndrome. Studies showed that exposure to air pollution is associated with an increased risk of insulin resistance in childhood. We determined whether the origin of type 2 diabetes can be found in the early childhood by examining the levels of insulin in the neonatal cord blood and whether this can be considered as a disease marker for later life...
May 22, 2017: Environment International
https://www.readbyqxmd.com/read/28545625/a-home-based-walking-program-improves-respiratory-endurance-in-patients-with-acute-myocardial-infarction-a-randomized-controlled-trial
#10
Bruna C Matos-Garcia, Isadora S Rocco, Lara D Maiorano, Thatiana C A Peixoto, Rita Simone L Moreira, Antonio C C Carvalho, Aparecida Maria Catai, Ross Arena, Walter J Gomes, Solange Guizilini
BACKGROUND: The purpose of this study was to evaluate respiratory muscle strength and endurance in the inpatient period in patients who recently experienced myocardial infarction (MI) and investigate the effects of a home-based walking program on respiratory strength and endurance in low-risk patients after MI. METHODS: Patients were randomized into a usual-care group (UCG) entailing regular care (n = 23) and an intervention group (IG) entailing an outpatient home-based walking program (n = 31)...
June 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28545514/a-coordinated-pcp-cardiologist-telemedicine-model-pctm-in-china-s-community-hypertension-care-study-protocol-for-a-randomized-controlled-trial
#11
Lei Xu, Wei-Yi Fang, Fu Zhu, Hong-Guang Zhang, Kai Liu
BACKGROUND: Hypertension is a major risk factor for cardiovascular disease, and its control rate has remained low worldwide. Studies have found that telemonitoring blood pressure (BP) helped control hypertension in randomized controlled trials. However, little is known about its effect in a structured primary care model in which primary care physicians (PCPs) are partnering with cardiology specialists in electronic healthcare data sharing and medical interventions. This study aims to identify the effects of a coordinated PCP-cardiologist model that applies telemedicine tools to facilitate community hypertension control in China...
May 25, 2017: Trials
https://www.readbyqxmd.com/read/28545502/improving-care-for-people-with-heart-failure-in-uganda-serial-in-depth-interviews-with-patients-and-their-health-care-professionals
#12
Elizabeth Namukwaya, Liz Grant, Julia Downing, Mhoira Leng, Scott A Murray
BACKGROUND: The short prognosis of patients with advanced heart failure (HF) and the associated multidimensional distress as illustrated in literature from high income countries necessitates the integration of palliative care into the care of advanced HF patients to address these needs and improve their quality of life. These needs, which are subjective, have not been described from the patients' and health care professionals'(HPs) view point in the Ugandan setting, a low income country with a different socio-cultural context...
May 25, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28545417/community-level-characteristics-and-environmental-factors-of-child-respiratory-illnesses-in-southern-arizona
#13
Nathan Lothrop, Khaleel Hussaini, Dean Billheimer, Paloma Beamer
BACKGROUND: Lower respiratory illnesses (LRIs) and asthma are common diseases in children <5 years of age. Few studies have investigated the relationships between multiple, home-based social and environmental risk factors and asthma and LRIs in children. Of those that have, none have focused exclusively on children <5 years of age, who are more physiologically vulnerable and spend more time at home compared to older children. Further, no studies have done so at the community level...
May 25, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28543780/intranasal-midazolam-versus-rectal-diazepam-for-the-management-of-canine-status-epilepticus-a-multicenter-randomized-parallel-group-clinical-trial
#14
M Charalambous, S F M Bhatti, L Van Ham, S Platt, N D Jeffery, A Tipold, J Siedenburg, H A Volk, D Hasegawa, A Gallucci, G Gandini, M Musteata, E Ives, A E Vanhaesebrouck
BACKGROUND: Intranasal administration of benzodiazepines has shown superiority over rectal administration for terminating emergency epileptic seizures in human trials. No such clinical trials have been performed in dogs. OBJECTIVE: To evaluate the clinical efficacy of intranasal midazolam (IN-MDZ), via a mucosal atomization device, as a first-line management option for canine status epilepticus and compare it to rectal administration of diazepam (R-DZP) for controlling status epilepticus before intravenous access is available...
May 24, 2017: Journal of Veterinary Internal Medicine
https://www.readbyqxmd.com/read/28543670/health-and-social-care-planning-in-collaboration-in-older-persons-homes-the-perspectives-of-older-persons-family-members-and-professionals
#15
Malin Sundström, Pia Petersson, Margareta Rämgård, Linda Varland, Kerstin Blomqvist
Providing health and social care to older persons is challenging, since older persons often have multiple diseases and a complex health situation. Hence many professions and organisations are involved. Lack of interprofessional and interorganisational collaboration leads to fragmented care. Care planning meetings before hospital discharge have long been used to overcome this fragmentation, but meetings conducted at the hospital have limitations in identifying long-term needs at home. A new model for health and social care planning in collaboration (HSCPC) in older persons' homes was introduced in two Swedish municipalities...
May 24, 2017: Scandinavian Journal of Caring Sciences
https://www.readbyqxmd.com/read/28542120/deaths-from-alzheimer-s-disease-united-states-1999-2014
#16
Christopher A Taylor, Sujay F Greenlund, Lisa C McGuire, Hua Lu, Janet B Croft
Alzheimer's disease (Alzheimer's), an ultimately fatal form of dementia, is the sixth leading cause of death in the United States, accounting for 3.6% of all deaths in 2014 (1,2). Alzheimer's deaths can be an indicator of paid and unpaid caregiver burden because nearly everyone in the final stages of Alzheimer's needs constant care, regardless of the setting, as the result of functional and cognitive declines (2). To examine deaths with Alzheimer's as the underlying cause, state-level and county-level death certificate data from the National Vital Statistics System for the period 1999-2014 were analyzed...
May 26, 2017: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/28541834/siblings-voices-a-prospective-investigation-of-experiences-with-a-dying-child
#17
Ceilidh Eaton Russell, Kimberley Widger, Laura Beaune, Alexandra Neville, Susan Cadell, Rose Steele, Adam Rapoport, Maria Rugg, Maru Barrera
Sibling relationships reflect a unique childhood bond, thus the impact on a sibling when a child is seriously ill or dying is profound. We conducted a prospective, longitudinal qualitative study over two years using interpretive descriptive methodology to understand siblings' perspectives when a brother or sister was dying at home or in hospital. The insights from the 10 siblings revealed complex experiences, both personal and with the ill child, their families, and peers. These experiences were paradoxically sources of strain and of support, revealing the importance of validation and normalization in assisting siblings to successfully navigate the experience...
May 25, 2017: Death Studies
https://www.readbyqxmd.com/read/28540343/psychosocial-well-being-associated-with-activity-of-daily-living-stages-among-community-dwelling-older-adults
#18
Ling Na, Joel E Streim
Objectives: Activity of daily living (ADL) stages demonstrated ordered associations with risk of chronic conditions, hospitalization, nursing home use, and mortality among community-living elderly. This article explores the association of stages with psychosocial well-being. We hypothesized that higher ADL stages (greater ADL limitation) are associated with more restricted social networks, less perceived social support, greater social isolation, and poorer mental health. Methods: Cross-sectional data from the National Social Life, Health, and Aging Project (N = 3,002) were analyzed in regression models and latent factor models...
January 2017: Gerontology & Geriatric Medicine
https://www.readbyqxmd.com/read/28540117/orthogeriatric-combined-management-of-elderly-patients-with-proximal-femoral-fracture-results-of-a-1-year-follow-up
#19
Stefan Förch, Reiner Kretschmer, Thomas Haufe, Johannes Plath, Edgar Mayr
INTRODUCTION: According to the expected demographical changes, the number of elderly trauma patients will increase exponentially over the next decades. Different models of an interdisciplinary orthogeriatric care have been developed. But there is only limited evaluation of their benefit without clear and evidence-based results. In 2011, we monitored the results of our orthogeriatric combined management by conducting a 1-year follow-up. METHODS: We treated 231 patients presenting a proximal femoral fracture on our orthogeriatric ward...
June 2017: Geriatric Orthopaedic Surgery & Rehabilitation
https://www.readbyqxmd.com/read/28539101/evaluation-of-early-versus-late-postdischarge-medication-reconciliation-on-readmission-rates-and-emergency-department-visits
#20
Tina Joseph, Rebecca A Barros, Elise Kim, Bupendra Shah
BACKGROUND: The current literature speculates ideal postdischarge follow-up focusing on transitions from hospital to home can range anywhere between 48 hours and 2 weeks. However, there is a lack of evidence regarding the optimal timing of follow-up visit to prevent readmissions. OBJECTIVE: The purpose of this study is to evaluate the impact of early (<48 hours) versus late (48 hours-14 days) postdischarge medication reconciliation on readmissions and emergency department (ED) use...
January 1, 2017: Journal of Pharmacy Practice
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