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https://www.readbyqxmd.com/read/28343236/effects-of-restricting-perioperative-use-of-intravenous-chloride-on-kidney-injury-in-patients-undergoing-cardiac-surgery-the-licra-pragmatic-controlled-clinical-trial
#1
David McIlroy, Deirdre Murphy, Jessica Kasza, Dhiraj Bhatia, Lisa Wutzlhofer, Silvana Marasco
PURPOSE: The administration of chloride-rich intravenous (IV) fluid and hyperchloraemia have been associated with perioperative renal injury. The aim of this study was to determine whether a comprehensive perioperative protocol for the administration of chloride-limited IV fluid would reduce perioperative renal injury in adults undergoing cardiac surgery. METHODS: From February 2014 through to December 2015, all adult patients undergoing cardiac surgery within a single academic medical center received IV fluid according to the study protocol...
March 25, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28343220/hemorrhagic-transformations-after-thrombectomy-risk-factors-and-clinical-relevance
#2
Johannes Kaesmacher, Mirjam Kaesmacher, Christian Maegerlein, Claus Zimmer, Alexandra S Gersing, Silke Wunderlich, Benjamin Friedrich, Tobias Boeckh-Behrens, Justus F Kleine
BACKGROUND: Hemorrhagic transformation (HT) is a major complication of acute ischemic stroke, potentially associated with clinical deterioration. We attempted to identify risk factors and evaluated clinical relevance of minor and major HTs following endovascular thrombectomy (ET) in isolated middle cerebral artery (MCA) occlusions. METHODS: This is a retrospective single-center analysis of 409 patients with isolated MCA occlusion treated with ET. Patients' and procedural characteristics, severity of HT according to the European Cooperative Acute Stroke Study criteria, and clinical outcomes were analyzed...
March 25, 2017: Cerebrovascular Diseases
https://www.readbyqxmd.com/read/28343191/the-impact-of-cigarette-smoking-alcohol-drinking-and-physical-inactivity-on-the-risk-of-urolithiasis-occurrence-and-recurrence
#3
Oryna Detsyk, Dmytro Solomchak
INTRODUCTION: Prevention of urolithiasis occurrence and recurrence is important issue, due to one affects mainly people of the working age and often leads to disability. AIM: To study the impact of harmful habits like smoking, alcohol drinking, and hypodynamics on the risk of urolithiasis occurrence and recurrence. MATERIALS AND METHODS: It was conducted a retrospective epidemiological study of a representative sample of 443 patients with urolithiasis (basic group, 403 - of them without recurrences and 40 - with recurrences) and 203 patients without urolithiasis - control group, at discharge them from urologic in-patient departments of health care facilities of Ivano-Frankivsk region...
2017: Wiadomości Lekarskie: Organ Polskiego Towarzystwa Lekarskiego
https://www.readbyqxmd.com/read/28343151/gastric-outlet-obstruction-an-unusual-case-of-primary-duodenal-tuberculosis
#4
Sanket Kalpande, Jayashri Sanjay Pandya, Ajeet Tiwari, Devbrata Adhikari
BACKGROUND: Tuberculosis is a major health problem worldwide. Gastrointestinal tuberculosis presenting as isolated involvement of the duodenum is a rare case. CASE PRESENTATION: A 13 year male, presented with features of gastric outlet obstruction. CT enterography scan showed circumferential mural thickening in first and second part of duodenal junction causing luminal narrowing. Upper GI endoscopy confirmed the narrowing of D1-D2 junction. Duodenal biopsy showed duodenitis with negative result for AFB stain, Helicobacter Pylori...
March 24, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28342937/molecular-epidemiology-of-staphylococcus-aureus-nasal-colonization-among-patients-and-their-parents-guardian-in-an-iranian-referral-hospital
#5
Babak Pourakbari, Mahmoud Khodabandeh, Shima Mahmoudi, Farah Sabouni, Alireza Aziz-Ahari, Abbas Bahador, Sepideh Keshavarz Valian, Reihaneh Hosseinpour Sadeghi, Setareh Mamishi
INTRODUCTION: Carriage of Staphylococcus aureus in the nose appears to play a key role in the epidemiology and pathogenesis of infection. It is important to investigate the genetic relatedness of S. aureus and MRSA clones in different geographic regions. The aim of this study was to assess the nasal carriage rate of S. aureus, including MRSA strains in both hospitalized children and general adult population (parents/guardian). In addition, antibiotic susceptibility pattern and molecular diversity of S...
March 22, 2017: Microbial Pathogenesis
https://www.readbyqxmd.com/read/28342829/effects-of-peer-mentoring-on-self-efficacy-and-hospital-readmission-following-inpatient-rehabilitation-of-individuals-with-spinal-cord-injury-a-randomized-controlled-trial
#6
Julie Gassaway, Michael L Jones, W Mark Sweatman, Minna Hong, Peter Anziano, Karen DeVault
OBJECTIVE: Investigate the effect of intensive peer mentoring on patient reported outcomes of self-efficacy and unplanned hospital readmissions for persons with spinal cord injury/disease (SCI/D) within the first 6 months after discharge from inpatient rehabilitation DESIGN: Randomized controlled trial; SETTING: Non-profit inpatient rehabilitation hospital specializing in care of persons with SCI/D and brain injury PARTICIPANTS: 158 patients admitted to the SCI rehabilitation program whose discharge location was a community setting...
March 22, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28342716/immediate-postpartum-intrauterine-device-and-implant-program-outcomes-a-prospective-analysis
#7
Jennifer L Eggebroten, Jessica N Sanders, David K Turok
BACKGROUND: In-hospital placement of intrauterine devices (IUD) and contraceptive implants following vaginal and cesarean delivery is increasingly popular and responds to maternal motivation for highly effective postpartum contraception. Immediate postpartum IUD insertion is associated with higher expulsion than interval placement, but emerging evidence suggests that the LNG IUD may have a higher expulsion rate than the Cu IUD. OBJECTIVE: This study evaluated in-hospital provision, expulsion and six month continuation of immediate postpartum copper T380 IUDs (Cu IUD), levonorgestrel (LNG) IUDs, and contraceptive implants...
March 22, 2017: American Journal of Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28342713/a-laboratory-score-at-presentation-to-rule-out-serious-cardiac-outcomes-or-death-in-patients-presenting-with-symptoms-suggestive-of-acute-coronary-syndrome
#8
Peter A Kavsak, Colleen Shortt, Jinhui Ma, Natasha Clayton, Jonathan Sherbino, Stephen A Hill, Matthew McQueen, Shamir R Mehta, P J Devereaux, Andrew Worster
BACKGROUND: We evaluated whether a low high-sensitivity cardiac troponin (hs-cTn) cutoff combined with glucose, red cell distribution width (RDW), and the estimated glomerular filtration rate (eGFR) can be used to rule-out a serious cardiac outcome or death in patients presenting with symptoms suggestive of acute coronary syndrome (ACS). METHODS: This was a prospective observational emergency department (ED) study enrolling consecutive patients presenting with symptoms suggestive of ACS (ClinicalTrials...
March 23, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28342705/comparison-of-20-mannitol-and-3-hypertonic-saline-on-intracranial-pressure-and-systemic-hemodynamics
#9
Navdeep Sokhal, Girija Prasad Rath, Arvind Chaturvedi, Manmohan Singh, Hari Hara Dash
Mannitol and hypertonic saline (HS) are most commonly used hyperosmotic agents for intraoperative brain relaxation. We compared the changes in ICP and systemic hemodynamics after infusion of equiosmolar solutions of both agents in patients undergoing craniotomy for supratentorial tumors. Forty enrolled adults underwent a standard anesthetic induction. Apart from routine monitoring parameters, subdural ICP with Codmann catheter and cardiac indices by Vigileo monitor, were recorded. The patients were randomized to receive equiosmolar solutions of either 20% mannitol (5ml/kg) or 3% HS (5...
March 22, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28342704/trends-in-the-presentation-surgical-treatment-and-outcomes-of-tethered-cord-syndrome-a-nationwide-study-from-2001-to-2010
#10
Cyrus M Jalai, Charles Wang, Bryan J Marascalchi, Samantha R Horn, Gregory W Poorman, Olivia J Bono, Anthony K Frempong-Boadu, Peter G Passias
OBJECTIVE: This is a nationwide query into surgical management techniques for tethered cord syndrome, focusing on patient demographic, hospital characteristics, and treatment outcomes. Our hypothesis is that detethering vs. fusion for TCS results in different in-hospital complications. MATERIALS AND METHODS: Retrospective review of the Nationwide Inpatient Sample 2001-2010. Inclusion: TCS discharges undergoing detethering or fusion. Sub-analysis compared TCS cases by age (pediatric [≤9years] vs...
March 22, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28342700/nicotine-replacement-therapy-in-patients-with-aneurysmal-subarachnoid-hemorrhage-systematic-review-of-the-literature-and-survey-of-canadian-practice
#11
REVIEW
Ricky D Turgeon, Stephano J Chang, Charlotte Dandurand, Peter A Gooderham, Camille Hunt
Tobacco smoke increases the risk of aneurysmal subarachnoid hemorrhage (SAH), as well as complications such as vasospasm. Most patients presenting with aneurysmal SAH smoke, and many survivors continue to smoke after discharge. Neurosurgeons often hesitate to use nicotine replacement therapy (NRT) during hospitalization of patients with SAH due to concerns of inducing vasospasm. We aimed to evaluate the safety and efficacy, and patterns of use of NRT in smokers hospitalized for SAH. We performed a systematic review of MEDLINE, CENTRAL, Embase, and unpublished sources of literature to October 2016 for randomized and observational studies comparing exposure to non-exposure of smoking cessation products in the acute phase of aneurysmal SAH...
March 22, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28342688/in-hospital-mortality-30-day-readmission-and-length-of-hospital-stay-after-surgery-for-primary-colorectal-cancer-a-national-population-based-study
#12
S Pucciarelli, M Zorzi, N Gennaro, G Gagliardi, A Restivo, M Saugo, A Barina, M Rugge, M Zuin, I Maretto, D Nitti
INTRODUCTION: The simultaneous assessment of multiple indicators for quality of care is essential for comparisons of performance between hospitals and health care systems. The aim of this study was to assess the rates of in-hospital mortality and 30-day readmission and length of hospital stay (LOS) in patients who underwent surgical procedures for colorectal cancer between 2005 and 2014 in Italy. METHODS: All patients in the National Italian Hospital Discharge Dataset who underwent a surgical procedure for colorectal cancer during the study period were included...
March 16, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28342684/persistent-pulmonary-hypertension-of-the-newborn
#13
REVIEW
Mamta Fuloria, Judy L Aschner
Failure of the normal circulatory adaptation to extrauterine life results in persistent pulmonary hypertension of the newborn (PPHN). Although this condition is most often secondary to parenchymal lung disease or lung hypoplasia, it may also be idiopathic. PPHN is characterized by elevated pulmonary vascular resistance with resultant right-to-left shunting of blood and hypoxemia. Although the preliminary diagnosis of PPHN is often based on differential cyanosis and labile hypoxemia, the diagnosis is confirmed by echocardiography...
March 23, 2017: Seminars in Fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/28342654/the-role-of-the-signal-intensity-ratio-on-fluid-attenuated-inversion-recovery-in-stroke-patients-achieving-successful-recanalization-with-endovascular-treatment
#14
Taehoon Kim, Jong-Won Chung, Myung Suk Jang, Mi Hwa Yang, Sang-Hwa Lee, Beom Joon Kim, Moon-Ku Han, Jae Hyoung Kim, Cheolkyu Jung, Jae-Sung Lim, Hee-Joon Bae
BACKGROUND: This study aimed to investigate whether fluid-attenuated inversion recovery (FLAIR) imaging hyperintensity can be used as a surrogate marker for the severity of ischemic insult and predict lesion growth. METHODS: Based on a prospective stroke registry database, we identified patients with ischemic stroke who were treated with endovascular treatment (EVT) within 8 hours of onset and achieved successful recanalization (modified thrombolysis in cerebral infarction ≥2B)...
March 22, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28342643/the-influence-of-pre-left-ventricular-assist-device-lvad-implantation-glomerular-filtration-rate-on-long-term-lvad-outcomes
#15
Burhan Mohamedali, Geetha Bhat
BACKGROUND: Chronic kidney disease (CKD) is a known predictor for adverse outcomes in patients with advanced heart failure requiring left ventricular assist devices (LVADs). The effect of pre-LVAD glomerular filtration rate (GFR) on post-LVAD outcomes in CKD patients is not completely understood. Additionally, a subset of patients improve their GFR after LVAD placement. In this study we sought to determine the effects of pre-LVAD GFR on post-LVAD outcomes. METHODS: Two hundred and seventy consecutive patients with LVADs were enrolled...
February 17, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28340494/postoperative-care-of-patients-with-high-grade-glioma-is-there-a-real-need-for-the-neurocritical-icu-and-early-ct-scan
#16
Roberto Altieri, Fabio Cofano, Alessandro Agnoletti, Riccardo Fornaro, Marco Ajello, Francesco Zenga, Alessandro Ducati, Diego Garbossa
Background Pressure on economic resources now requires a careful rationalization of services. For adult patients with supratentorial gliomas, there is no consensus on the real need for care in a postoperative neurocritical intensive care unit (NICU) and on the timing of a postsurgical computed tomography (CT) scan. In this retrospective nonrandomized study, we assessed if and when there is a real need for NICU and if an early CT scan could be justified in the absence of neurologic worsening. Methods Of 264 patients, 21 were admitted to the NICU after the procedure as planned before the surgery for their clinical features (Karnofsky performance status < 70, American Society of Anesthesiologists score > 2, or Charlson Comorbidity Index > 5)...
March 24, 2017: Journal of Neurological Surgery. Part A, Central European Neurosurgery
https://www.readbyqxmd.com/read/28340218/user-centered-design-of-discharge-warnings-tool-for-colorectal-surgery-patients
#17
Aanand D Naik, Molly J Horstman, Linda T Li, Michael K Paasche-Orlow, Bryan Campbell, Whitney L Mills, Levi I Herman, Daniel A Anaya, Barbara W Trautner, David H Berger
Objectives: Readmission following colorectal surgery, typically due to surgery-related complications, is common. Patient-centered discharge warnings may guide recognition of early complication signs after colorectal surgery. Materials and Methods: User-centered design of a discharge warnings tool consisted of iterative health literacy review and a heuristic evaluation with human factors and clinical experts as well as patient end users to establish content validity and usability...
March 16, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28340017/patient-reporting-of-undesirable-events-a-pilot-study-in-china
#18
Jia Yan, Ke Liu, Lifeng Zhang, Ting Chu, Xuehua Wang
Objective: To identify the frequency of undesirable events reported by patients during hospitalization and explore the relationship between undesirable events and perception of safety and satisfaction with care in China. Design: Cross-sectional survey. Setting: Chinese university hospital. Participants: Adult patients (N = 341) discharged from medical and surgical departments. Interventions: Patients were interviewed post-discharge using a survey instrument to ask whether they had experienced specific undesirable events during hospitalization...
March 10, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28340013/implications-of-thoracic-epidural-analgesia-on-hospital-charges-in-rib-fracture-patients
#19
Courtney D Jensen, Jamie T Stark, Lewis E Jacobson, Jan M Powers, Kathy L Leslie, Jeffrey M Kinsella-Shaw, Michael F Joseph, Craig R Denegar
Objective.:  Rib fractures are present in more than 150,000 patients admitted to US trauma centers each year. Those who fracture two or more ribs are typically treated with oral analgesic drugs and are discharged with few complications. The cost of this care generally reflects its brevity. When a patient fractures three or more ribs, there is an elevated risk of complication. In response, treatments are often broadened and their durations prolonged; this affects cost. While health, function, and survival have been widely explored, patient billing has not...
March 7, 2017: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28339702/subclinical-chronic-left-ventricular-systolic-dysfunction-resulting-from-phosphine-poisoning
#20
E Szymczyk, M Wiszniewska, J Walusiak-Skorupa, J D Kasprzak, P Lipiec
We present a case of a 32-year-old male crew member of a cargo ship, accidentally exposed to phosphine, a fumigating substance. He and other crew members developed increasing fatigue and digestive disorders 24 h later; two died from acute pulmonary oedema. The patient was admitted to hospital, where bilateral pneumonia, acute nephritis, hepatopathy, electrolyte imbalance and leucopenia were diagnosed. He was discharged from hospital 3 weeks later. He was examined 4 months later for possible chronic consequences of acute phosphine poisoning, which included echocardiography showing normal heart size and cardiac function...
February 21, 2017: Occupational Medicine
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