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https://www.readbyqxmd.com/read/28212474/-zinc-phosphide-poisoning-in-pediatric-patients-from-a-toxicology-center-at-mexico-city
#1
María Carmen Socorro Sánchez-Villegas, Alejandro Bárcena-Ruiz
BACKGROUND: Zinc phosphide is a chemical compound that is frequently used as a rodenticide; it is a highly toxic product that is widely used, among other spaces, at home. Given that it is a highly commercialized pesticide and that there is no antidote, it is mandatory to establish favorably the clinical manifestations of the intoxication. The aim was to describe the epidemiological and clinical profile of children intoxicated with zinc phosphide attended in a toxicological center of a tertiary referral hospital...
2017: Revista Médica del Instituto Mexicano del Seguro Social
https://www.readbyqxmd.com/read/28211155/utah-obstetricians-opinions-of-planned-home-birth-and-conflicting-nice-acog-guidelines-a-qualitative-study
#2
Emily Rainey, Sara Simonsen, Joseph Stanford, Kimberley Shoaf, Jami Baayd
BACKGROUND: The United Kingdom's National Institute for Health and Care Excellence (NICE) recently published recommendations that support planned home birth for low-risk women. The American College of Obstetricians and Gynecologists (ACOG) remains wary of planned home birth, asserting that hospitals and birthing centers are the safest birth settings. Our objective was to examine opinions of obstetricians in Salt Lake City, Utah about home birth in the context of rising home birth rates and conflicting guidelines...
February 17, 2017: Birth
https://www.readbyqxmd.com/read/28209484/successful-provision-of-inter-hospital-extracorporeal-cardiopulmonary-resuscitation-for-acute-post-partum-pulmonary-embolism
#3
C McDonald, J Laurie, S Janssens, C Zazulak, P Kotze, K Shekar
Mortality during pregnancy in a well-resourced setting is rare, but acute pulmonary embolism is one of the leading causes. We present the successful use of extracorporeal cardiopulmonary resuscitation (eCPR) in a 22-year old woman who experienced cardiopulmonary collapse following urgent caesarean section in the setting of a sub-massive pulmonary embolus. Resources and personnel to perform eCPR were not available at the maternity hospital and were recruited from an adjacent pediatric hospital. Initial care used low blood flow extracorporeal membrane oxygenation (ECMO) with pediatric ECMO circuitry, which was optimized when the team from a nearby adult cardiac hospital arrived...
January 9, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28208967/early-discharge-of-preterm-infants-an-indian-perspective
#4
Ankit Soni, Sandeep Kadam, Anand Pandit, Sanjay Patole
INTRODUCTION: Early home discharge of preterm infants is a priority in developing countries due to bed shortage and poor socio-economic status. There is wide variation in home discharge policies for preterm infants. Limited data exists on optimal timing for discharging such infants. In view of the socio-economic and medico-legal importance of the issue, we aimed to study the outcomes of our ex-preterm infants discharged home 'early', to guide our clinical practice. AIM: To study the rates of re-admissions/mortality within 4 weeks after discharge in preterm (born <34 weeks) infants...
December 2016: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/28207971/emergency-department-initiated-home-oxygen-for-bronchiolitis-a-prospective-study-of-community-follow-up-caregiver-satisfaction-and-outcomes
#5
Julia Fuzak Freeman, Sara Deakyne, Lalit Bajaj
OBJECTIVE: Retrospective studies performed have shown home oxygen to be a safe alternative to hospitalization for some patients with bronchiolitis living at high altitudes. We aimed to prospectively describe adverse events, follow-up, duration of home oxygen, factors associated with failure, and caregiver preferences. METHODS: This was a prospective observational study of hypoxemic bronchiolitis patients ages 3-18months who were discharged from a tertiary care pediatric emergency department on home oxygen over 3 winters (2011-2014)...
February 16, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28205323/an-evaluation-of-the-costs-and-consequences-of-children-community-nursing-teams
#6
Sebastian Hinde, Victoria Allgar, Gerry Richardson, Gemma Spiers, Gillian Parker, Yvonne Birks
AIMS: Recent years have seen an increasing shift towards providing care in the community, epitomised by the role of Children's Community Nursing (CCN) teams. However, there have been few attempts to use robust evaluative methods to interrogate the impact of such services. This study sought to evaluate whether reduction in secondary care costs, resulting from the introduction of 2 CCN teams, was sufficient to offset the additional cost of commissioning. METHODS: Among the potential benefits of the CCN teams is a reduction in the burden placed on secondary care through the delivery of care at home; it is this potential reduction which is evaluated in this study via a 2-part analytical method...
February 16, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28205207/home-uterine-monitoring-for-detecting-preterm-labour
#7
REVIEW
Christine Urquhart, Rosemary Currell, Francoise Harlow, Liz Callow
BACKGROUND: To reduce the morbidity and mortality associated with preterm birth, home uterine activity monitoring aims for early detection of increased contraction frequency, and early intervention with tocolytic drugs to inhibit labour and prolong pregnancy. However, the effectiveness of such monitoring is disputed. OBJECTIVES: To determine whether home uterine activity monitoring is effective in improving the outcomes for women and their infants considered to be at high risk of preterm birth, when compared with care that does not include home uterine activity monitoring...
February 15, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28202769/project-impact-pilot-report-feasibility-of-implementing-a-hospital-to-home-transition-bundle
#8
Leah A Mallory, Snezana Nena Osorio, B Stephen Prato, Jennifer DiPace, Lisa Schmutter, Paula Soung, Amanda Rogers, William J Woodall, Kayla Burley, Sandra Gage, David Cooperberg
BACKGROUND AND OBJECTIVES: To improve hospital to home transitions, a 4-element pediatric patient-centered transition bundle was developed, including: a transition readiness checklist; predischarge teach-back education; timely and complete written handoff to the primary care provider; and a postdischarge phone call. The objective of this study was to demonstrate the feasibility of bundle implementation and report initial outcomes at 4 pilot sites. Outcome measures included postdischarge caregiver ability to teach-back key home management information and 30-day reuse rates...
February 15, 2017: Pediatrics
https://www.readbyqxmd.com/read/28199891/the-epidemiologic-characteristics-temporal-trends-predictors-of-death-and-discharge-disposition-in-patients-with-a-diagnosis-of-sepsis-a-cross-sectional-retrospective-cohort-study
#9
Sarah Elfeky, Pegah Golabi, Munkhzul Otgonsuren, Svetolik Djurkovic, Mary E Schmidt, Zobair M Younossi
PURPOSE: To assess recent epidemiologic characteristics, temporal trends, and predictors of death and discharge disposition in patients with sepsis. MATERIAL AND METHODS: This is a cross-sectional retrospective cohort study using the US National Inpatient Sample (NIS) data from 2009 to 2012. The study population included adults (18years and older) with sepsis-related International Classification of Diseases, Ninth Revision, Clinical Modification codes at the time of discharge...
January 20, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28197294/diagnostic-approach-to-myocarditis-mimicking-myocardial-infarction-at-initial-presentation
#10
Craig Basman, Pratik R Agrawal, Chad McRee, Louis Saravolatz, Carol Chen-Scarabelli, Tiziano M Scarabelli
We present a case of a 35-year-old male patient with a 12-hour history of sudden-onset, crushing chest pain and associated complaints of profuse diaphoresis, nausea and vomiting. The patient was transferred to our institution from an outside hospital for evaluation and possible emergent catheterization. Left heart catheterization was conclusive for normal coronary arteries and a ventriculogram revealed a left ventricular ejection fraction of approximately 45%. Due to a suspicion of myocarditis based on clinical history, pertinent serology tests were ordered, which were found to be negative...
December 2016: Cardiology Research
https://www.readbyqxmd.com/read/28196524/financial-barriers-and-adverse-clinical-outcomes-among-patients-with-cardiovascular-related-chronic-diseases-a-cohort-study
#11
David J T Campbell, Braden J Manns, Robert G Weaver, Brenda R Hemmelgarn, Kathryn M King-Shier, Claudia Sanmartin
BACKGROUND: Some patients with cardiovascular-related chronic diseases such as diabetes and heart disease report financial barriers to achieving optimal health. Previous surveys report that the perception of having a financial barrier is associated with self-reported adverse clinical outcomes. We sought to confirm these findings using linked survey and administrative data to determine, among patients with cardiovascular-related chronic diseases, if there is an association between perceived financial barriers and the outcomes of: (1) disease-related hospitalizations, (2) all-cause mortality and (3) inpatient healthcare costs...
February 15, 2017: BMC Medicine
https://www.readbyqxmd.com/read/28196486/integrated-care-at-home-reduces-unnecessary-hospitalizations-of-community-dwelling-frail-older-adults-a-prospective-controlled-trial
#12
Laura Di Pollina, Idris Guessous, Véronique Petoud, Christophe Combescure, Bertrand Buchs, Philippe Schaller, Michel Kossovsky, Jean-Michel Gaspoz
BACKGROUND: Care of frail and dependent older adults with multiple chronic conditions is a major challenge for health care systems. The study objective was to test the efficacy of providing integrated care at home to reduce unnecessary hospitalizations, emergency room visits, institutionalization, and mortality in community dwelling frail and dependent older adults. METHODS: A prospective controlled trial was conducted, in real-life clinical practice settings, in a suburban region in Geneva, Switzerland, served by two home visiting nursing service centers...
February 14, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28193321/acute-rehabilitation-after-trauma-does-it-really-matter
#13
Deepika Nehra, Zeynep A Nixon, Claudia Lengenfelder, Eileen M Bulger, Joseph Cuschieri, Ronald V Maier, Saman Arbabi
BACKGROUND: The impact of post-discharge rehabilitation care for the trauma patient remains poorly investigated. Here we describe the functional outcomes of trauma patients discharged to an inpatient rehabilitation facility (IRF), and compare the likelihood of discharge home, 1-year rehospitalization, and 1-year mortality between patients discharged to an IRF and a propensity score-matched cohort of patients not discharged to an IRF. STUDY DESIGN: The Washington State Rehabilitation Registry was used to collect data for all trauma patients discharged to an IRF between 2011 and 2012...
December 2016: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28192226/use-of-preventive-medication-in-patients-with-limited-life-expectancy-a-systematic-review
#14
REVIEW
Arjun Poudel, Patsy Yates, Debra Rowett, Lisa M Nissen
CONTEXT: Optimal prescribing in patients with limited life expectancy remains unclear. OBJECTIVES: This study systematically reviews the published literature regarding the use of preventive medication in patients with reduced life expectancy. METHODS: A systematic literature search was conducted using three databases (MEDLINE, EMBASE and CINAHL). Articles published in English from January 1995 to December 2015 were retrieved for analysis to identify peer-reviewed, observational studies assessing use of preventive medications in patients with limited life expectancy...
February 9, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/28192055/a-community-checklist-for-health-sector-resilience-informed-by-hurricane-sandy
#15
Eric S Toner, Meghan McGinty, Monica Schoch-Spana, Dale A Rose, Matthew Watson, Erin Echols, Eric G Carbone
This is a checklist of actions for healthcare, public health, nongovernmental organizations, and private entities to use to strengthen the resilience of their community's health sector to disasters. It is informed by the experience of Hurricane Sandy in New York and New Jersey and analyzed in the context of findings from other recent natural disasters in the United States. The health sector is defined very broadly, including-in addition to hospitals, emergency medical services (EMS), and public health agencies-healthcare providers, outpatient clinics, long-term care facilities, home health providers, behavioral health providers, and correctional health services...
January 2017: Health Security
https://www.readbyqxmd.com/read/28190375/trends-in-place-of-death-the-role-of-demographic-and-epidemiological-shifts-in-end-of-life-care-policy
#16
Jorid Kalseth, Ole Magnus Theisen
BACKGROUND: Surveys suggest that most people prefer to die at home. Trends in causes of mortality and age composition could limit the feasibility of home deaths. AIM: To examine the effect of changes in decedents' age, gender and cause of death on the pattern of place of death using data on all deaths in Norway for the period 1987-2011. DESIGN: Population-based observation study comparing raw, predicted, as well as standardised shares of place of death isolating the effect of demographic and epidemiological changes...
February 1, 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28188268/design-and-rationale-of-a-randomized-trial-of-a-care-transition-strategy-in-patients-with-acute-heart-failure-discharged-from-the-emergency-department-guided-hf-get-with-the-guidelines-in-emergency-department-patients-with-heart-failure
#17
Gregory J Fermann, Phillip D Levy, Peter Pang, Javed Butler, S Imran Ayaz, Douglas Char, Patrick Dunn, Cathy A Jenkins, Christy Kampe, Yosef Khan, Vijaya A Kumar, JoAnn Lindenfeld, Dandan Liu, Karen Miller, W Frank Peacock, Samaa Rizk, Chad Robichaux, Russell L Rothman, Jon Schrock, Adam Singer, Sarah A Sterling, Alan B Storrow, Cheryl Walsh, John Wilburn, Sean P Collins
: GUIDED-HF (Get With the Guidelines in Emergency Department Patients With Heart Failure) is a multicenter randomized trial of a patient-centered transitional care intervention in patients with acute heart failure (AHF) who are discharged either directly from the emergency department (ED) or after a brief period of ED-based observation. To optimize care and reduce ED and hospital revisits, there has been significant emphasis on improving transitions at the time of hospital discharge for patients with HF...
February 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/28188152/perineal-resuturing-versus-expectant-management-following-vaginal-delivery-complicated-by-a-dehisced-wound-preview-a-nested-qualitative-study
#18
L Dudley, C Kettle, J Waterfield, Khaled M K Ismail
OBJECTIVE: To explore women's lived experiences of a dehisced perineal wound following childbirth and how they felt participating in a pilot and feasibility randomised controlled trial (RCT). DESIGN: A nested qualitative study using semistructured interviews, underpinned by descriptive phenomenology. PARTICIPANTS AND SETTING: A purposive sample of six women at 6-9 months postnatal who participated in the RCT were interviewed in their own homes...
February 10, 2017: BMJ Open
https://www.readbyqxmd.com/read/28186639/a-retrospective-cohort-study-of-hospital-versus-home-care-for-pregnant-women-with-preterm-prelabor-rupture-of-membranes
#19
Lynne Palmer, Kirsten Grabowska, Jason Burrows, Hilary Rowe, Erin Billing, Amy Metcalfe
OBJECTIVE: To compare maternal and neonatal outcomes between in-hospital management and prepartum care at home (PCAH) among women with preterm prelabor rupture of membranes (PPROM) before 34 weeks of pregnancy. METHODS: In a retrospective study, data were analyzed from women who experienced PPROM between 23 and 34 weeks of pregnancy, and received care from two hospitals in British Columbia, Canada, between April 2007 and March 2012. Women were included if they had been stable in hospital for at least 72 hours and met eligibility criteria for PCAH...
February 10, 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28186453/effects-of-distance-and-transport-method-on-intervention-and-mortality-in-aneurysmal-subarachnoid-hemorrhage
#20
Jonathan Weyhenmeyer, Cristian F Guandique, Adam Leibold, Stephen Lehnert, Jonathan Parish, Woody Han, Chad Tuchek, Janit Pandya, Thomas Leipzig, Troy Payner, Andrew DeNardo, John Scott, Aaron A Cohen-Gadol
OBJECTIVE Most patients suffering from aneurysmal subarachnoid hemorrhage (aSAH) initially present to a hospital that lacks a neurosurgical unit. These patients require interhospital transfer (IHT) to tertiary facilities capable of multidisciplinary neurosurgical intervention. Yet, little is known about the effects of IHT on the outcomes of patients suffering from aSAH. In this study, the authors examined the effects of IHT and transport method on the timing of treatment, rebleed rates, and overall outcomes of patients who have experienced aSAH...
February 10, 2017: Journal of Neurosurgery
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