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https://www.readbyqxmd.com/read/27914358/defining-the-role-of-perioperative-statin-treatment-in-patients-after-cardiac-surgery-a-meta-analysis-and-systematic-review-of-20-randomized-controlled-trials
#1
Xin Yuan, Jianlin Du, Qi Liu, Ling Zhang
BACKGROUND: Although statin use has been indicated to prevent atrial fibrillation in previous observational and experimental trials, the issue remains inadequately and insufficiently explored. We therefore performed this meta-analysis to evaluate the effects of perioperative statin therapy on complications and short-term prognosis following cardiac surgery. METHODS: A search of the PubMed, EMBASE and the Cochrane database of controlled trials was performed from inception to June 2016 to identify relevant randomized controlled trials (RCTs)...
November 9, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27914158/causes-of-death-in-an-acute-psychiatric-inpatient-unit-of-a-portuguese-general-hospital
#2
Sofia Barbosa, Márcia Sequeira, Sara Castro, Rita Manso, Catarina Klut Câmara, Bruno Trancas, Nuno Borja-Santos, Teresa Maia
INTRODUCTION: Psychiatric patients are at increased risk of death from a number of natural and unnatural causes. This study examines the mortality causes of all psychiatric inpatients of an acute psychiatric unit at a general hospital in Portugal for sixteen years (1998 to 2013). MATERIAL AND METHODS: Twenty-one inpatients died at the inpatient unit between 1998 and 2013 (average 1.3 per year). A retrospective study through case-file review was carried to collect demographic characteristics, medical and psychiatry diagnosis...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27914153/-pulmonary-embolism-in-portugal-epidemiology-and-in-hospital-mortality
#3
Miguel Gouveia, Luís Pinheiro, João Costa, Margarida Borges
INTRODUCTION: In Portugal, the epidemiology of acute pulmonary embolism is poorly understood. In this study, we sought to characterize the pulmonary embolism from the hospital data and evaluate its in-hospital mortality and respective prognostic factors. MATERIAL AND METHODS: The study used diagnostic related groups data from National Health System hospitals from 2003 to 2013 and National Statistics Institute population data to establish the evolution of admissions with the diagnosis of pulmonary embolism, their inhospital mortality rates and the population incidence rates...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27913784/the-effectiveness-of-the-bone-bridge-transtibial-amputation-technique-a-systematic-review-of-high-quality-evidence
#4
Jason T Kahle, M Jason Highsmith, John Kenney, Tim Ruth, Paul A Lunseth, Janos Ertl
BACKGROUND: This literature review was undertaken to determine if commonly held views about the benefits of a bone bridge technique are supported by the literature. METHODS: Four databases were searched for articles pertaining to surgical strategies specific to a bone bridge technique of the transtibial amputee. A total of 35 articles were identified as potential articles. Authors included methodology that was applied to separate topics. Following identification, articles were excluded if they were determined to be low quality evidence or not pertinent...
December 1, 2016: Prosthetics and Orthotics International
https://www.readbyqxmd.com/read/27913775/role-of-b-type-natriuretic-peptide-in-predicting-in-hospital-outcomes-in-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-with-preserved-left-ventricular-function-a-5-year-retrospective-analysis
#5
Saraschandra Vallabhajosyula, Toufik Mahfood Haddad, Pranathi R Sundaragiri, Anas A Ahmed, Muhammad Sarfraz Nawaz, Hamza A A Rayes, Harish C Devineni, Arun Kanmanthareddy, Dustin A McCann, Christopher S Wichman, Ariel M Modrykamien, Lee E Morrow
BACKGROUND: The role of B-type natriuretic peptide (BNP) is less understood in the risk stratification of patients with an acute exacerbation of chronic obstructive pulmonary disease (AECOPD), especially in patients with normal left ventricular ejection fraction (LVEF). METHODS: This retrospective study from 2008 to 2012 evaluated all adult patients with AECOPD having BNP levels and available echocardiographic data demonstrating LVEF ≥40%. The patients were divided into groups 1, 2, and 3 with BNP ≤ 100, 101 to 500, and ≥501 pg/mL, respectively...
December 2, 2016: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/27913754/neurological-manifestations-in-children-with-dengue-fever-an-indian-perspective
#6
Archan Sil, Tamoghna Biswas, Moumita Samanta, Mithun Chandra Konar, Arun Kumar De, Jasodhara Chaudhuri
Ours was a descriptive observational cross-sectional study carried out in a tertiary care hospital in eastern India over a period of one year to study the profile of neurological involvement in paediatric dengue patients. Of 71 laboratory-confirmed cases, 20 (28.17%) had neurological involvement. Common forms observed were acute encephalopathy (40%), encephalitis (30%), pure motor weakness (15%), transverse myelitis (5%), acute disseminated encephalomyelitis (5%) and Guillain-Barré syndrome (5%). The dengue IgM antibody could be detected in the cerebrospinal fluid of only two patients with encephalitis...
December 2, 2016: Tropical Doctor
https://www.readbyqxmd.com/read/27913722/impact-of-a-multidisciplinary-round-visit-for-the-management-of-dysphagia-utilizing-a-wi-fi-based-wireless-flexible-endoscopic-evaluation-of-swallowing
#7
Koichi Sakakura, Masayuki Tazawa, Natsuko Otani, Masato Takagi, Mariko Morita, Minori Kurosaki, Tomoko Chiyoda, Yuri Kanai, Ayaka Endo, Takaaki Murata, Masato Shino, Yuki Yokobori, Kenji Shirakura, Naoki Wada, Kazuaki Chikamatsu
OBJECTIVES: The management of dysphagia requires a multidisciplinary approach, especially in large-scale hospitals. We introduce a novel protocol using a Wi-Fi-based flexible endoscopic evaluation of swallowing (FEES) system and aim to verify its effectiveness in evaluation and rehabilitation of inpatients with dysphagia. METHOD: We conducted novel Wi-Fi-based FEES at the bedside using 3 iPads as monitors and recorders. Functional outcomes of swallowing in 2 different hospitals for acute care with conventional wired or wireless FEES were compared retrospectively...
January 2017: Annals of Otology, Rhinology, and Laryngology
https://www.readbyqxmd.com/read/27913536/reversal-of-direct-oral-anticoagulants-a-practical-approach
#8
Andrew W Shih, Mark A Crowther
Direct oral anticoagulants (DOACs) have at least noninferior efficacy compared with other oral anticoagulants and have ancillary benefits, including overall better safety profiles, lack of the need for routine monitoring, rapid onset of action, and ease of administration. Reversal of these agents may be indicated in certain situations such as severe bleeding and for perioperative management. DOAC-associated bleeding should be risk stratified: patients with moderate or severe bleeding should have the DOAC discontinued and reversal strategies should be considered...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913531/treatment-of-older-patients-with-acute-lymphoblastic-leukemia
#9
Nicola Gökbuget
The treatment of older patients with acute lymphoblastic leukemia (ALL) is an unmet medical need. With increasing age, ALL patients have a significantly lower clinical remission rate, higher early mortality, higher relapse rate, and poorer survival compared with younger patients. This is only partly explained by a higher incidence of poor prognostic factors in the older age group. Most importantly, intensive chemotherapy with or without stem cell transplantation (SCT) is less well tolerated in older patients...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913463/single-dose-intravenous-iron-for-iron-deficiency-a-new-paradigm
#10
Michael Auerbach, Thomas Deloughery
Iron-deficiency anemia is the most common hematologic problem in the world. Although oral iron is often viewed as front-line therapy, extensive published evidence has accumulated that IV iron is superior, in both efficacy and safety, to oral iron in many clinical situations and should be introduced much sooner in the treatment paradigm of iron-deficient patients. In this chapter, we will review the formulations of IV iron that allow total complete replacement doses in 1 or 2 sessions including practical tips for administration...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913457/treatment-of-blastic-plasmacytoid-dendritic-cell-neoplasm
#11
Jill M Sullivan, David A Rizzieri
Blastic plasmacytoid dendritic cell neoplasm (BPDCN) is a rare myeloid malignancy with no defined standard of care. BPDCN presents most commonly with skin lesions with or without extramedullary organ involvement before leukemic dissemination. As a result of its clinical ambiguity, differentiating BPDCN from benign skin lesions or those of acute myeloid leukemia with leukemia cutis is challenging. BPDCN is most easily defined by the phenotype CD4(+)CD56(+)CD123(+)lineage(-)MPO(-), although many patients will present with variable expression of CD4, CD56, or alternate plasmacytoid markers, which compounds the difficulty in differentiating BPDCN from other myeloid or lymphoid malignancies...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27912997/postacute-care-in-cancer-rehabilitation
#12
REVIEW
Ying Guo, Jack B Fu, Hong Guo, Jennifer Camp, Ki Y Shin, Shi-Ming Tu, Lynn J Palmer, Rajesh Yadav
Acute care is usually associated with disease progression, treatments for cancer, and medical comorbidities. Patients with cancer may develop sudden functional deficits that require rehabilitation. Some of these patients benefit from acute rehabilitation, others benefit from subacute rehabilitation. After acute rehabilitation, continuous care for these patients has not been well described. Three studies are presented to demonstrate that cancer rehabilitation is a continuous process. Rehabilitation professionals should know how to detect fall risk, monitor symptoms, and render symptom management...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27912992/brain-tumors-and-metastases
#13
REVIEW
Mary M Vargo
Patients with brain tumor exhibit wide-ranging prognoses and functional implications of their disease and treatments. In general, the supportive care needs of patients with brain tumor, including disabling effects, have been recognized to be high. This review (1) briefly summarizes brain tumor types, treatments, and prognostic information for the rehabilitation clinician; (2) reviews evidence for rehabilitation, including acute inpatient rehabilitation and cognitive rehabilitation, and the approaches to selected common symptom and medical management issues; and (3) examines emerging data about survivorship, such as employment, community integration, and fitness...
February 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/27912923/predictors-of-30-day-mortality-in-patients-admitted-to-emergency-departments-for-acute-heart-failure
#14
Matthieu Marchetti, Antoine Benedetti, Olivier Mimoz, Jean-Yves Lardeur, Jérémy Guenezan, Nicolas Marjanovic
OBJECTIVES: Acute heart failure (AHF) is a leading cause of admission in emergency departments (ED). It is associated with significant in-hospital mortality, suggesting that there is room for improvement of care. Our aims were to investigate clinical patterns, biological characteristics and determinants of 30-day mortality. METHODS: We conducted a single site, retrospective review of adult patients (≥18years) admitted to ED for AHF over a 12-month period. Data collected included demographics, clinical, biological and outcomes data...
November 22, 2016: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/27912902/evolution-of-the-clinical-profile-of-patients-with-acute-heart-failure-treated-in-spanish-emergency-departments
#15
R Escoda, Ò Miró, F J Martín-Sánchez, J Jacob, P Herrero, V Gil, J M Garrido, M J Pérez-Durá, M Fuentes, P Llorens
OBJECTIVE: To analyse the changes in epidemiology, outpatient and emergency department clinical care, and outcomes of patients treated for acute heart failure (AHF) in Spanish hospital emergency departments (HEDs) between 2007 and 2014. METHOD: A multicentre cohort study was conducted that consecutively included patients with AHF diagnosed in 9HEDs during 4 periods (2007, 2009, 2011 and 2014). The study analysed the changes observed in 20 variables corresponding to baseline data, outpatient care and emergency care data and outcome data...
November 29, 2016: Revista Clínica Española
https://www.readbyqxmd.com/read/27912248/mean-arterial-blood-pressure-management-of-acute-spinal-cord-injured-patients-during-the-pre-hospital-and-early-admission-period
#16
Jin Wee Tee, Farhaan Altaf, Lise M Belanger, Tamir Ailon, John Street, Scott J Paquette, Michael C Boyd, Charles G Fisher, Marcel F Dvorak, Brian K Kwon
The optimization and maintenance of mean arterial blood pressure (MAP) and the general avoidance of systemic hypotension for the first 5 to 7 days following acute traumatic SCI is considered to be important for minimizing secondary spinal cord ischemic damage. The characterization of hemodynamic parameters in the immediate post-injury stage prior to admission to a specialized spine unit has not been previously reported. Here we describe the blood pressure management of 40 acute tSCI patients in the early post-injury phases of care prior to their arrival in a specialized spinal injury high dependency unit (HDU), intensive care unit (ICU) or operating room (OR)...
December 2, 2016: Journal of Neurotrauma
https://www.readbyqxmd.com/read/27911489/palliative-care-interventions-in-advanced-dementia
#17
REVIEW
Edel Murphy, Katherine Froggatt, Sheelah Connolly, Eamon O'Shea, Elizabeth L Sampson, Dympna Casey, Declan Devane
BACKGROUND: Dementia is a chronic, progressive and ultimately fatal neurodegenerative disease. Advanced dementia is characterised by profound cognitive impairment, inability to communicate verbally and complete functional dependence. Usual care of people with advanced dementia is not underpinned universally by a palliative approach. Palliative care has focused traditionally on care of people with cancer but for more than a decade, there have been increased calls worldwide to extend palliative care services to include all people with life-limiting illnesses in need of specialist care, including people with dementia...
December 2, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27911487/external-inspection-of-compliance-with-standards-for-improved-healthcare-outcomes
#18
REVIEW
Gerd Flodgren, Daniela C Gonçalves-Bradley, Marie-Pascale Pomey
BACKGROUND: Inspection systems are used in healthcare to promote quality improvements (i.e. to achieve changes in organisational structures or processes, healthcare provider behaviour and patient outcomes). These systems are based on the assumption that externally promoted adherence to evidence-based standards (through inspection/assessment) will result in higher quality of healthcare. However, the benefits of external inspection in terms of organisational-, provider- and patient-level outcomes are not clear...
December 2, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27911381/a-novel-approach-for-the-administration-of-medications-and-fluids-in-emergency-scenarios-and-settings
#19
Akilesh Honasoge, Neal Lyons, Kathleen Hesse, Braden Parker, Robert Mokszycki, Kelly Wesselhoff, Rolla Sweis, Erik B Kulstad
The available routes of administration commonly used for medications and fluids in the acute care setting are generally limited to oral, intravenous, or intraosseous routes, but in many patients, particularly in the emergency or critical care settings, these routes are often unavailable or time-consuming to access. A novel device is now available that offers an easy route for administration of medications or fluids via rectal mucosal absorption (also referred to as proctoclysis in the case of fluid administration and subsequent absorption)...
November 9, 2016: Journal of Visualized Experiments: JoVE
https://www.readbyqxmd.com/read/27911313/challenges-in-screening-and-recruitment-for-a-neuroimaging-study-in-cognitively-impaired-geriatric-inpatients
#20
Ivayla Apostolova, Catharina Lange, Anna Roberts, Hans Joachim Igel, Anja Mäurer, Stephanie Liese, Melanie Estrella, Vikas Prasad, Elisabeth Stechl, Gernot Lämmler, Elisabeth Steinhagen-Thiessen, Ralph Buchert
BACKGROUND: Neuroimaging-based biomarkers have the potential to improve etiological diagnosis of cognitive impairment in elderly inpatients. However, there is a relative lack of studies on neuroimaging-based biomarkers in hospitalized geriatric patients, as the vast majority of neuroimaging studies in dementia have focused on memory clinic outpatients. An important aspect of study planning is a priori estimation of the rate of screen failures. OBJECTIVE: To report on the rate and causes of screen failures in a prospective study on the utility of neuroimaging (PET, MRI) for the etiological diagnosis of newly manifested cognitive impairment in acutely hospitalized geriatric patients...
November 28, 2016: Journal of Alzheimer's Disease: JAD
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