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https://www.readbyqxmd.com/read/28214078/the-optimize-heart-failure-care-program-initial-lessons-from-global-implementation
#1
Martin R Cowie, Yuri M Lopatin, Clara Saldarriaga, Cândida Fonseca, David Sim, Jose Antonio Magaña, Denilson Albuquerque, Marcelo Trivi, Gustavo Moncada, Baldomero A González Castillo, Mario Osvaldo Speranza Sánchez, Edward Chung
Hospitalization for heart failure (HF) places a major burden on healthcare services worldwide, and is a strong predictor of increased mortality especially in the first three months after discharge. Though undesirable, hospitalization is an opportunity to optimize HF therapy and advise clinicians and patients about the importance of continued adherence to HF medication and regular monitoring. The Optimize Heart Failure Care Program (www.optimize-hf.com), which has been implemented in 45 countries, is designed to improve outcomes following HF hospitalization through inexpensive initiatives to improve prescription of appropriate drug therapies, patient education and engagement, and post-discharge planning...
February 12, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28212601/feasibility-of-identifying-out-of-care-hiv-positive-patients-in-a-hospital-setting-and-enrolling-them-in-a-retention-intervention
#2
Jessica A Davila, Christine Hartman, Jeffrey Cully, Melinda Stanley, K Rivet Amico, Elizabeth Soriano, Sophie Minick, Sarah B May, Thomas P Giordano
BACKGROUND: The hospital setting provides an opportunity to re-engage people living with HIV (PLWH) in HIV care. We developed and implemented a protocol to identify PLWH in a hospital setting. The aim of the current study was to report on our strategy to recruit hospitalized HIV patients into an intervention study, and to report on lessons learned for future studies. METHODS: Our protocol was developed based on experience of our research staff in recruiting HIV patients as well as clinical input from providers and administrators on delivering care in hospitalized settings...
February 17, 2017: HIV Clinical Trials
https://www.readbyqxmd.com/read/28208149/distal-middle-cerebral-artery-branch-recanalization-does-not-affect-final-lesion-volume-in-ischemic-stroke
#3
Verena van Ginneken, Daniel Gierhake, Heinrich J Audebert, Jochen B Fiebach
BACKGROUND: Early recanalization in ischemic stroke is associated with favorable outcome. However, limited data are available on the effect of recanalization on infarct growth and functional outcome in stroke with distal middle cerebral artery (MCA) pathology. This study was aimed at determining the effect of recanalization in acute stroke patients with perfusion-diffusion mismatch and occlusion or high-grade stenosis of a distal MCA branch. METHODS: We prospectively examined 34 consecutive stroke patients with perfusion-diffusion mismatch and M3 or M4 pathology within 24 h of symptom onset...
February 17, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28198198/comparative-evaluation-of-pain-stress-neuropeptide-y-acth-and-cortisol-levels-between-a-conventional-postoperative-care-protocol-and-a-fast-track-recovery-program-in-patients-undergoing-major-abdominal-surgery
#4
Maria Kapritsou, Elizabeth D Papathanassoglou, Evangelos Bozas, Dimitrios P Korkolis, Evangelos A Konstantinou, Ioannis Kaklamanos, Margarita Giannakopoulou
BACKGROUND: Fast-track (FT) postoperative protocol in oncological patients after major abdominal surgery reduces complications and length of postoperative stay compared to the conventional (CON) protocol. However, stress and pain responses have not been compared between the two protocols. OBJECTIVES: To compare stress, pain, and related neuropeptidic responses (adrenocorticotropic hormone [ACTH], cortisol, and neuropeptide Y [NPY]) between FT and CON protocols. METHOD: A clinical trial with repeated measurements was conducted (May 2012 to May 2014) with a sample of 63 hepatectomized or pancreatectomized patients randomized into two groups: FT ( n = 29) or CON ( n = 34)...
March 2017: Biological Research for Nursing
https://www.readbyqxmd.com/read/28190560/filtering-authentic-sepsis-arising-in-the-icu-using-administrative-codes-coupled-to-a-sirs-screening-protocol
#5
Christopher L Sudduth, Elizabeth C Overton, Peter F Lyu, Ramzy H Rimawi, Timothy G Buchman
PURPOSE: Using administrative codes and minimal physiologic and laboratory data, we sought a high-specificity identification strategy for patients whose sepsis initially appeared during their ICU stay. MATERIALS AND METHODS: We studied all patients discharged from an academic hospital between September 1, 2013 and October 31, 2014. Administrative codes and minimal physiologic and laboratory criteria were used to identify patients at high risk of developing the onset of sepsis in the ICU...
February 3, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28190553/cervical-spine-imaging-for-young-children-with-inflicted-trauma-expanding-the-injury-pattern
#6
Joanne Baerg, Arul Thirumoorthi, Rosemary Vannix, Asma Taha, Amy Young, Alexander Zouros
AIM: The purpose of this study was to document the incidence and pattern of cervical spine (c-spine) injuries in children below 36months with inflicted trauma. METHODS: An IRB approved, prospective cohort study was performed between July 2011 and January 2016. Inclusion criteria were: age below 36months, loss of consciousness after inflicted trauma, and one initial head computed tomography finding: a subdural, intraventricular, intraparenchymal, subarachnoid hemorrhage, diffuse axonal injury, hypoxic injury, or cerebral edema...
January 30, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28190549/comparing-del-nido-and-conventional-cardioplegia-in-infants-and-neonates-in-congenital-heart-surgery
#7
Kamal K Pourmoghadam, Mark Ruzmetov, Michael C O'Brien, Kurt D Piggott, Gary Plancher, Sukumar Suguna Narasimhulu, Tavya Benjamin, William M Decampli
BACKGROUND: The aim of this study was to evaluate outcome measures after the use of del Nido (dN) cardioplegia compared with conventional multidose high-potassium (non-dN) cardioplegia in neonates and infants. METHODS: We retrospectively analyzed data in patients, aged younger than 1 year, undergoing cardiopulmonary bypass (CPB) from January 2012 to August 2015. We changed our cardioplegia protocol from non-dN to dN administered in a single or infrequently dosed strategy in September 2013...
February 9, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28188966/where-to-go-if-not-the-hospital-reviewing-geriatric-bed-utilization-in-an-acute-care-hospital-in-singapore
#8
Ke Zhou, Arpana R Vidyarthi, Chek Hooi Wong, David Matchar
AIM: Singapore is one of the fastest-aging countries in the world, and the demand for acute hospital care for older adults is expected to triple in the next 25 years. Hence, it is crucial to understand the opportunities in reducing potentially avoidable bed days (PABD), which are days spent in acute hospitals delivering only non-acute services. We aimed to access the prevalence, causes and consequences of PABD among geriatric patients. METHODS: We examined all hospitalizations from 1 August through 31 December 2013 in the geriatric wards of an acute hospital in Singapore...
February 11, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/28186928/collecting-biological-material-from-palliative-care-patients-in-the-last-weeks-of-life-a-feasibility-study
#9
Séamus Coyle, Aileen Scott, Amara Callistus Nwosu, Richard Latten, James Wilson, Catriona R Mayland, Stephen Mason, Chris Probert, John Ellershaw
OBJECTIVE: To assess the feasibility of prospectively collecting biological samples (urine) from palliative care patients in the last weeks of life. SETTING: A 30-bedded specialist hospice in the North West of England. PARTICIPANTS: Participants were adults with a diagnosis of advanced disease and able to provide written informed consent. METHOD: Potential participants were identified by a senior clinician over a 12-week period in 2014...
November 10, 2016: BMJ Open
https://www.readbyqxmd.com/read/28185641/enhanced-recovery-after-surgery-in-gastric-resections
#10
Marcos Bruna Esteban, Peter Vorwald, Sonia Ortega Lucea, Jose Manuel Ramírez Rodríguez
INTRODUCTION: Enhanced recovery after surgery is a modality of perioperative management with the purpose of improving results and providing a faster recovery of patients. This kind of protocol has been applied frequently in colorectal surgery, presenting less available experience and evidence in gastric surgery. METHODS: According to the RICA guidelines published in 2015, a review of the bibliography and the consensus established in a multidisciplinary meeting in Zaragoza on the 9th of October 2015, we present a protocol that contains the basic procedures of fast-track for resective gastric surgery...
February 6, 2017: Cirugía Española
https://www.readbyqxmd.com/read/28183335/efficacy-of-vitamin-d3-supplementation-in-reducing-incidence-of-pulmonary-tuberculosis-and-mortality-among-hiv-infected-tanzanian-adults-initiating-antiretroviral-therapy-study-protocol-for-a-randomized-controlled-trial
#11
Christopher R Sudfeld, Ferdinand Mugusi, Said Aboud, Tumaini J Nagu, Molin Wang, Wafaie W Fawzi
BACKGROUND: HIV-infected adults initiating antiretroviral therapy (ART) in sub-Saharan Africa continue to experience high rates of morbidity and mortality during the initial months of treatment. Observational studies in high-income and resource-limited settings indicate that HIV-infected adults with low vitamin D levels may be at increased risk of mortality, HIV disease progression, and incidence of pulmonary tuberculosis (TB). As a result, vitamin D3 supplementation may improve survival and treatment outcomes for HIV-infected adults initiating ART...
February 10, 2017: Trials
https://www.readbyqxmd.com/read/28183322/impact-of-a-pharmacist-led-medication-review-on-hospital-readmission-in-a-pediatric-and-elderly-population-study-protocol-for-a-randomized-open-label-controlled-trial
#12
Pierre Renaudin, Karine Baumstarck, Aurélie Daumas, Marie-Anne Esteve, Stéphane Gayet, Pascal Auquier, Michel Tsimaratos, Patrick Villani, Stéphane Honore
BACKGROUND: Early hospital readmission of patients after discharge is a public health problem. One major cause of hospital readmission is dysfunctions in integrated pathways between community and hospital care that can cause adverse drug events. Furthermore, the French ENEIS 2 study showed that 1.3% of hospital stays originated from serious adverse drug events in 2009. Pharmacy-led medication reviews at hospital transitions are an effective means of decreasing medication discrepancies when conducted at admission or discharge...
February 9, 2017: Trials
https://www.readbyqxmd.com/read/28181920/can-early-rehabilitation-on-the-general-ward-after-an-intensive-care-unit-stay-reduce-hospital-length-of-stay-in-survivors-of-critical-illness-a-randomized-controlled-trial
#13
Wolfgang Gruther, Karin Pieber, Irene Steiner, Cornelia Hein, Jörg Michael Hiesmayr, Tatjana Paternostro-Sluga
OBJECTIVE: The aim of this study was to evaluate if an early rehabilitation program for survivors of critical illness improves functional recovery, reduces length of stay, and reduces hospital costs. DESIGN: This was a prospective randomized controlled trial. Fifty-three consecutive survivors of critical illness were included in the study. After discharge from the intensive care unit, the intervention group received an early rehabilitation program, and the standard-care group received physical therapy as ordered by the primary care team...
February 8, 2017: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/28176972/factors-associated-with-relapse-in-adult-patients-discharged-from-the-emergency-department-following-acute-asthma-a-systematic-review
#14
Jesse Hill, Nicholas Arrotta, Cristina Villa-Roel, Liz Dennett, Brian H Rowe
A significant proportion of patients discharged from the emergency department (ED) with asthma exacerbations will relapse within 4 weeks. This systematic review summarises the evidence regarding relapses and factors associated with relapse in adult patients discharged from EDs after being treated for acute asthma. Following a registered protocol, comprehensive literature searches were conducted. Studies tracking outcomes for adults after ED management and discharge were included if they involved adjusted analyses...
2017: BMJ Open Respiratory Research
https://www.readbyqxmd.com/read/28174148/local-anesthesia-versus-local-anesthesia-and-conscious-sedation-for-inguinal-hernioplasty-protocol-of-a-randomized-controlled-trial
#15
Pierre-Anthony Leake, Patrick J Toppin, Marvin Reid, Joseph M Plummer, Patrick O Roberts, Hyacinth Harding-Goldson, Michael E McFarlane
BACKGROUND: Conscious sedation is regularly used in ambulatory surgery to improve patient outcomes, in particular patient satisfaction. Reports suggest that the addition of conscious sedation to local anesthesia for inguinal hernioplasty is safe and effective in improving patient satisfaction. No previous randomized controlled trial has assessed the benefit of conscious sedation in this regard. OBJECTIVE: To determine whether the addition of conscious sedation to local anesthesia improves patient satisfaction with inguinal hernioplasty...
February 7, 2017: JMIR Research Protocols
https://www.readbyqxmd.com/read/28167641/prognostic-utility-of-a-modified-heart-score-in-chest-pain-patients-in-the-emergency-department
#16
James McCord, Rafael Cabrera, Bertil Lindahl, Evangelos Giannitsis, Kaleigh Evans, Richard Nowak, Tiberio Frisoli, Richard Body, Michael Christ, Christopher R deFilippi, Robert H Christenson, Gordon Jacobsen, Aitor Alquezar, Mauro Panteghini, Dina Melki, Mario Plebani, Franck Verschuren, John French, Garnet Bendig, Silvia Weiser, Christian Mueller
BACKGROUND: The TRAPID-AMI trial study (High-Sensitivity Troponin-T Assay for Rapid Rule-Out of Acute Myocardial Infarction) evaluated high-sensitivity cardiac troponin-T (hs-cTnT) in a 1-hour acute myocardial infarction (AMI) exclusion algorithm. Our study objective was to evaluate the prognostic utility of a modified HEART score (m-HS) within this trial. METHODS AND RESULTS: Twelve centers evaluated 1282 patients in the emergency department for possible AMI from 2011 to 2013...
February 2017: Circulation. Cardiovascular Quality and Outcomes
https://www.readbyqxmd.com/read/28166446/use-of-intranasal-naloxone-by-basic-life-support-providers
#17
Scott G Weiner, Patricia M Mitchell, Elizabeth S Temin, Breanne K Langlois, K Sophia Dyer
STUDY OBJECTIVES: Intranasal delivery of naloxone to reverse the effects of opioid overdose by Advanced Life Support (ALS) providers has been studied in several prehospital settings. In 2006, in response to the increase in opioid-related overdoses, a special waiver from the state allowed administration of intranasal naloxone by Basic Life Support (BLS) providers in our city. This study aimed to determine: 1) if patients who received a 2-mg dose of nasal naloxone administered by BLS required repeat dosing while in the emergency department (ED), and 2) the disposition of these patients...
February 6, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28164831/therapeutic-hypothermia-at-an-urban-public-hospital-development-implementation-experience-and-outcomes
#18
Renaud M Gueret, John M Bailitz, Ashima S Sahni, Aiman Tulaimat
BACKGROUND: Therapeutic hypothermia (TH) improves the outcome of comatose patients suffering an out-of-hospital sudden cardiac arrest (SCA) with shockable rhythm and return of spontaneous circulation (ROSC). Evidence supporting its use in other circumstances is weak and the adoption of TH remains limited. OBJECTIVE: Describe the development and implementation of a TH program at an urban public hospital and report outcomes of out-of-hospital and in-hospital SCA and important quality measures...
January 2017: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/28162210/-surgical-treatment-and-prognosis-of-ductal-carcinoma-in-situ-526-cases-analysis
#19
S J Zhu, X S Chen, J Y Wu, O Huang, J R He, L Zhu, W G Chen, Y F Li, X C Fei, K W Shen
Objective: To evaluate the choice of surgical treatment of ductal carcinoma in situ (DCIS) and its impact on long-term outcomes. Methods: A retrospective analysis of the clinicopathological features and treatment protocol of DCIS patients who underwent surgical treatment in Comprehensive Breast Health Center, Ruijin Hospital, Shanghai Jiaotong University School of Medicine from January 2009 to August 2016 was done. The factors which could affect surgical treatment were analyzed by χ(2) test and Logistic regression...
February 1, 2017: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/28161482/evaluation-of-a-standardized-risk-based-venous-thromboembolism-prophylaxis-protocol-in-the-setting-of-thyroid-and-parathyroid-surgery
#20
Ryan Macht, Ivy Gardner, Stephanie Talutis, Pamela Rosenkranz, Gerard Doherty, David McAneny
BACKGROUND: An elevated odds ratio for venous thromboembolism (VTE) prompted the development of a Caprini risk assessment and risk-based prophylaxis protocol for all General Surgery patients. This system includes pre- and post-operative prophylactic heparin as well as extended courses of low molecular weight heparin for high-risk patients. This study evaluates the safety of this chemoprophylaxis program in thyroid and parathyroid surgery. STUDY DESIGN: A retrospective review was conducted of all General Surgery patients undergoing thyroid or parathyroid operations after the implementation of the Caprini prophylaxis protocol...
February 1, 2017: Journal of the American College of Surgeons
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