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https://www.readbyqxmd.com/read/29150972/patient-level-factors-and-the-quality-of-care-delivered-in-pediatric-emergency-departments
#1
James P Marcin, Patrick S Romano, Parul Dayal, Madan Dharmar, James M Chamberlain, Nanette Dudley, Charles G Macias, Lise E Nigrovic, Elizabeth C Powell, Alexander J Rogers, Meridith Sonnett, Leah Tzimenatos, Elizabeth R Alpern, Rebecca Andrews-Dickert, Dominic A Borgialli, Erika Sidney, T Charles Casper, J Michael Dean, Nathan Kuppermann
OBJECTIVE: Quality of care delivered to adult patients in the emergency department (ED) is often associated with demographic and clinical factors such as a patient's race/ethnicity and insurance status. We sought to determine whether the quality of care delivered to children in the ED was associated with a variety of patient-level factors. METHODS: This was a retrospective, observational cohort study. Pediatric patients (<18 years) who received care between January 2011 and December 2011 at one of twelve EDs participating in the Pediatric Emergency Care Applied Research Network (PECARN) were included...
November 18, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29150812/factors-influencing-platelet-transfusion-refractoriness-in-patients-undergoing-allogeneic-hematopoietic-stem-cell-transplantation
#2
Pilar Solves, Jaime Sanz, Carmen Freiria, Marta Santiago, Ana Villalba, Inés Gómez, Pau Montesinos, Juan Montoro, Jose Luis Piñana, José Ignacio Lorenzo, Nieves Puig, Guillermo F Sanz, Miguel Ángel Sanz, Nelly Carpio
Hematopoietic stem cell transplantation has been considered a risk factor for development of platelet transfusion refractoriness. The objective of this study was to assess the platelet transfusion refractoriness rate in patients undergoing allogeneic hematopoietic stem cell transplantation from different sources. We retrospectively reviewed the charts and transfusion records of patients who underwent allogeneic stem cell transplantation at our institution between 2013 and 2015. The evaluation of post-transfusion platelet count was assessed for each transfusion given, from day of progenitor infusion to day 30 after transplantation...
November 17, 2017: Annals of Hematology
https://www.readbyqxmd.com/read/29150477/risk-factors-for-recurrent-intussusception-in-children-a-retrospective-cohort-study
#3
Wan-Liang Guo, Zhang-Chun Hu, Ya-Lan Tan, Mao Sheng, Jian Wang
OBJECTIVE: The aim of this study was to assess the frequency of clinical features and pathological lead points in recurrent intussusception, with a special focus on the risk factors that lead to recurrent intussusception. DESIGN: This is a retrospective cohort study. A 5-year retrospective study was performed between January 2012 and July 2016 in the Children's Hospital of Soochow University, Suzhou, China, to determine the clinical features and pathological lead points of recurrent intussusception...
November 16, 2017: BMJ Open
https://www.readbyqxmd.com/read/29150316/low-threshold-extended-release-naltrexone-for-high-utilizers-of-public-services-with-severe-alcohol-use-disorder-a-pilot-study
#4
Shannon Smith-Bernardin, Chris Rowe, Emily Behar, Michelle Geier, Stuart Washington, Glenn-Milo Santos, Jason Euren, Judith Martin, Alice Gleghorn, Phillip O Coffin
Extended-release naltrexone (XRNTX) is an effective treatment for alcohol use disorder (AUD). We sought to evaluate the feasibility, acceptability, and preliminary effectiveness and cost-effectiveness of XRNTX delivered as a stand-alone service to persons with severe AUD who are high utilizers of multiple urgent and emergency medical services (HUMS). Of 15 HUMS persons with severe AUD selected based on chart review, 11 agreed to participate. Participants received a mean of 4.5 injections (range 2-7). Modest benefits from XRNTX were observed in terms of patients' Urge-to-Drink Score and the costs of emergency medical services utilized...
November 8, 2017: Journal of Substance Abuse Treatment
https://www.readbyqxmd.com/read/29150284/the-displacing-foods-of-modern-commerce-are-the-primary-and-proximate-cause-of-age-related-macular-degeneration-a-unifying-singular-hypothesis
#5
Chris A Knobbe, Marija Stojanoska
Age-related macular degeneration (AMD) is the leading cause of irreversible vision loss and blindness in developed nations. AMD is anticipated to affect 196 million people worldwide, by 2020. However, the etiology of this disease remains unknown. Aging, genetic, and environmental influences have generally been implicated as major etiologic factors. We sought to examine the hypothesis that consumption of the 'displacing foods of modern commerce,' which equate to processed, nutrient-deficient and potentially toxic foods, may be the primary and proximate cause of AMD...
November 2017: Medical Hypotheses
https://www.readbyqxmd.com/read/29150195/anatomic-findings-associated-with-epispadias-in-boys-implications-for-surgical-management-and-urinary-continence
#6
M Cendron, P S Cho, M Pennison, I Rosoklija, D A Diamond, J G Borer
INTRODUCTION: Pre-operative physical examination of male epispadias allows for classification of epispadias level as glanular (GE), penile (PE) or penopubic (PPE), and for delineation of anatomic anomalies. The incidence of associated extragenital abnormalities, such as vesicoureteral reflux (VUR), bladder neck (BN) abnormality and abnormal pubic diastasis (PD), and their impact on urinary continence has not yet been systematically studied. OBJECTIVE: The goal of this study was to evaluate whether the more proximal level of epispadias correlated with associated extragenital anatomic anomalies seen on initial imaging or endoscopic evaluation, and whether these pre-operative findings contributed to subsequent surgical management and impacted on achieving urinary continence...
October 26, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/29150192/thirty-day-reoperation-and-or-admission-after-elective-hand-surgery-in-adults-a%C3%A2-10-year-review
#7
Avi D Goodman, Joseph A Gil, Adam M Starr, Edward Akelman, Arnold-Peter C Weiss
PURPOSE: Whereas acute complications following elective hand surgery have been assumed to be rare, the incidence of 30-day unplanned reoperation and/or admission for the most common elective procedures has not been well described. Our goal was to calculate the incidence and identify the risk factors associated with these complications in a busy academic practice. METHODS: Our institution's quality assurance database was examined retrospectively for unplanned reoperations and/or admissions within 30 days in adults undergoing elective procedures with 2 senior attending surgeons from February 2006 to January 2016...
November 15, 2017: Journal of Hand Surgery
https://www.readbyqxmd.com/read/29149953/myocardial-perfusion-scans-and-mortality-in-asymptomatic-patients-awaiting-renal-transplantation
#8
A Jauhal, S Harenberg, J J Crawford, I Bare, B Prasad, L Zahorski, G Ollenberger, V Trivedi, V Chopra, A Shoker, A Lavoie, P Dehghani
Cardiac risk assessment for asymptomatic patients awaiting renal transplantation is controversial. Patients awaiting renal transplantation in Southern Saskatchewan from 2005 to 2015 were retrospectively reviewed. Patients underwent cardiac risk stratification with stress myocardial perfusion scan. Baseline clinical characteristics, nuclear scan results, all-cause mortality, and cardiovascular events were analyzed. Abnormal scans were defined as studies with reversible defects, wall motion abnormalities, lung uptake, or transient ischemic dilation...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29149952/financial-impact-of-incidental-radiologic-findings-during-living-kidney-donor-evaluation
#9
A Mutneja, L Saling, M Yano, A Vijayan
Living kidney donor (LKD) transplantation is an important alternative for the end-stage renal disease population and is preferred due to superior outcomes when compared with dialysis or deceased donor transplantation. LKD evaluation includes a computed tomography angiogram (CTA) for assessment of renal and renovascular anatomy. Incidental nonrenal findings are frequently noted during the CTAs, and these may have variable clinical significance. These incidental findings lead to further testing, procedures, and referrals, which incur additional cost...
November 2017: Transplantation Proceedings
https://www.readbyqxmd.com/read/29149770/a-multicenter-retrospective-medical-record-review-of-x-linked-myotubular-myopathy-the-recensus-study
#10
Alan H Beggs, Barry J Byrne, Sabine de Chastonay, Tmirah Haselkorn, Imelda Hughes, Emma S James, Nancy L Kuntz, Jennifer Simon, Lindsay C Swanson, Michele L Yang, Zi-Fan Yu, Sabrina W Yum, Suyash Prasad
INTRODUCTION: X-linked myotubular myopathy (XLMTM), characterized by severe hypotonia, weakness, respiratory distress, and early mortality, is rare and natural history studies are few. METHODS: RECENSUS is a multicenter chart review of male XLMTM patients characterizing disease burden and unmet medical needs. Data were collected between September 2014 and June 2016. RESULTS: Analysis included 112 patients at six clinical sites. Most recent patient age recorded was ≤18 months for 40 patients and >18 months for 72 patients...
November 17, 2017: Muscle & Nerve
https://www.readbyqxmd.com/read/29149171/risk-factors-for-hospitalizations-among-patients-with-cirrhosis-a-prospective-cohort-study
#11
Shari S Rogal, Viyan Udawatta, Imo Akpan, Akshata Moghe, Alexis Chidi, Amit Shetty, Eva Szigethy, Klaus Bielefeldt, Andrea DiMartini
This study was designed to assess unique baseline factors associated with subsequent hospitalizations in a cohort of outpatients with cirrhosis. A cohort of 193 patients with cirrhosis was recruited from an outpatient liver disease clinic at a single, tertiary medical center. Comorbidities, prescription medications, liver disease symptoms and severity, and psychiatric and pain symptoms were assessed at baseline using validated instruments. Inflammatory markers were measured using standardized Luminex assays...
2017: PloS One
https://www.readbyqxmd.com/read/29149156/survival-analysis-of-occipital-nerve-stimulator-leads-placed-under-fluoroscopic-guidance-with-and-without-ultrasonography
#12
James H Jones, Alison Brown, Daniel Moyse, Wenjing Qi, Lance Roy
BACKGROUND: Electrical stimulation of the greater occipital nerves is performed to treat pain secondary to chronic daily headaches and occipital neuralgia. The use of fluoroscopy alone to guide the surgical placement of electrodes near the greater occipital nerves disregards the impact of tissue planes on lead stability and stimulation efficacy. OBJECTIVE: We hypothesized that occipital neurostimulator (ONS) leads placed with ultrasonography combined with fluoroscopy would demonstrate increased survival rates and times when compared to ONS leads placed with fluoroscopy alone...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29149152/loss-of-efficacy-to-spinal-cord-stimulator-therapy-clinical-evidence-and-possible-causes
#13
Christopher M Aiudi, Roger Y Dunn, Sara M Burns, Sarah A Roth, Arissa Opalacz, Yi Zhang, Lucy Chen, Jianren Mao, Shihab U Ahmed
BACKGROUND: Although spinal cord stimulation (SCS) therapy has been shown to be efficacious in various pain conditions, the ability for SCS therapy to maintain long-term efficacy has been questioned. OBJECTIVE: The purpose of this study was to investigate whether a loss of efficacy (LOE) phenomenon exists with SCS therapy and to investigate if this phenomenon is more apparent in any specific patient population. STUDY DESIGN: A retrospective, observation chart review was conducted to evaluate the patient response to SCS therapy over time...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29148861/a-new-approach-for-determining-short-term-objective-prognostic-predictive-methods-for-terminal-cancer-patients-based-on-the-change-point-of-laboratory-test-values
#14
Kazuyuki Niki, Yoshiaki Okamoto, Yoshitaka Tabata, Mamiko Tsugane, Taizo Murata, Masao Mizuki, Yasushi Matsumura, Tatsuya Takagi, Etsuko Uejima
BACKGROUND: In terminal phase cancer, predicting a prognosis precisely plays an important role for patients and their families to live meaningful lives. However, there are no established short-term, objective prognostic predictive methods. OBJECTIVE: To develop simple, short-term, objective prognostic predictive methods through detecting a change point for laboratory test values. DESIGN: A retrospective chart review. SETTING/SUBJECTS: Subjects were cancer patients aged ≥16 years and discharged dead from Osaka University Hospital in 2008...
November 17, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29147897/vacuum-assisted-wound-closure-with-mesh-mediated-fascial-traction-achieves-better-outcomes-than-vacuum-assisted-wound-closure-alone-a-comparative-study
#15
Giuseppe Salamone, Leo Licari, Giovanni Guercio, Albert Comelli, Mirko Mangiapane, Nicolò Falco, Roberta Tutino, Noemi Bagarella, Sofia Campanella, Calogero Porrello, Roberto Gullo, Gianfranco Cocorullo, Gaspare Gulotta
BACKGROUND: Open abdomen (OA) permits the application of damage control surgery principles when abdominal trauma, sepsis, severe acute peritonitis and abdominal compartmental syndrome (ACS) occur. METHODS: Non-traumatic patients treated with OA between January 2010 and December 2015 were identified in a prospective database, and the data collected were retrospectively reviewed. Patients' records were collected from charts and the surgical and intensive care unit (ICU) registries...
November 16, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29147880/targeted-physician-education-and-standardizing-documentation-improves-documented-reporting-with-inflammatory-bowel-disease-quality-measures-in-a-large-academic-and-private-practice
#16
Joseph D Feuerstein, Konstantinos Papamichael, Sara Popejoy, Adam Nadelson, Jeffrey J Lewandowski, Kathy Geissler, Manuel Martinez-Vazquez, Daniel A Leffler, Kim Ariyabuddhiphongs, Chandrashekhar Thukral, Adam S Cheifetz
BACKGROUND: Prior studies have shown poor compliance with quality measures for IBD at academic and private practices. We sought to provide focused interventions to improve compliance and documentation with the IBD measures. METHODS: Two centers, academic practice (AP) and private practice (PP), initially reviewed their compliance with eight established IBD quality measures in consecutive charts. A multi-faceted intervention was developed to improve awareness and documentation of these measures...
November 17, 2017: Digestive Diseases and Sciences
https://www.readbyqxmd.com/read/29147631/automated-whole-brain-tractography-affects-preoperative-surgical-decision-making
#17
Hesham Zakaria, Sameah Haider, Ian Lee
Surgery in and around eloquent brain structures poses a technical challenge when the goal of surgery is maximal safe resection. Magnetic resonance imaging (MRI) has revolutionized the diagnosis and treatment of neurological disorders, but tractography still remains limited in terms of utility because of the requisite manual labor and time required combined with the high risk of bias and inaccuracy. Automated whole brain tractography (AWBT) has simplified this workflow, overcoming historical barriers, and allowing for integration into modern neuronavigation...
September 6, 2017: Curēus
https://www.readbyqxmd.com/read/29147470/retrospective-analysis-of-inferior-vena-cava-collapsibility-with-point-of-care-ultrasound-and-urine-sodium-and-fena-in-patients-with-early-stage-acute-kidney-injury
#18
Faizan Babar, Gurkeerat Singh, Mustafa Noor, Bruce Sabath
Early stage acute kidney injury (AKI) is an independent risk factor for an increase in mortality. Accurate assessment of volume status is a major challenge during the early stages of acute renal injury. Determining volume status based on the history and physical exam lacks accuracy. Urine sodium and free excretion of sodium (FENa) provide objective evidence of intravascular volume status when interpreted carefully and is helpful to delineate prerenal from intrinsic renal failure. In recent years point of care ultrasound has been used to assess volume status...
2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29147468/use-of-dictation-as-a-tool-to-decrease-documentation-errors-in-electronic-health-records
#19
Samer Al Hadidi, Sunil Upadhaya, Rupal Shastri, Zain Alamarat
Background: Use of Electronic Health Records is increasing. Copy-and-paste function is frequently used with higher rates of documentation errors. Studies to determine the nature of such errors are needed.Objectives: Determination of the effect of implementing a dictation system for completing notes on the quality of clinical documentation. We hypothesized that implementation of the dictation system for note writing would decrease the rate of errors in the progress notes as well as decrease the rate of copying and pasting...
2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29147082/impact-of-pathology-review-for-decision-therapy-in-localized-prostate-cancer
#20
Pedro Luiz Serrano Usón, Ricardo Silvestre E Silva Macarenco, Fernando Nunes Oliveira, Oren Smaletz
Background: The Gleason score is an essential tool in the decision to treat localized prostate cancer. However, experienced pathologists can classify Gleason score differently than do low-volume pathologists, and this may affect the treatment decision. This study sought to assess the impact of pathology review of external biopsy specimens from 23 men with a recent diagnosis of localized prostate cancer. Methods: All external biopsy specimens were reviewed at our pathology department...
2017: Clinical Medicine Insights. Pathology
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