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https://www.readbyqxmd.com/read/29149796/effectiveness-of-treatment-in-wards-for-patients-with-dementia-and-issues-associated-with-this-treatment-a-prospective-analysis
#1
Shogo Taniguchi, Teruyuki Matsuoka, Takeshi Hikawa, Atsushi Machihara, Keisuke Shibata, Hideki Miki, Hiroshi Shimizu, Jin Narumoto
In order to optimize the treatment in wards for patients with dementia, we investigated predictors of the length of stay in the ward for patients with dementia. A prospective analysis of 72 patients with dementia was conducted in two wards for patients with dementia. Severity of dementia was assessed by the Clinical Dementia Rating, basic activities of daily living were evaluated using the Physical Self-Maintenance Scale, and severity of behavioral and psychological symptoms of dementia and caregiver distress were determined with the Nursing Home version of the Neuropsychiatric Inventory...
January 1, 2017: Dementia
https://www.readbyqxmd.com/read/29149618/effectiveness-of-a-patient-centred-empowerment-based-intervention-programme-among-patients-with-poorly-controlled-type-2-diabetes-a-randomised-controlled-trial
#2
Li Cheng, Janet W H Sit, Kai-Chow Choi, Sek-Ying Chair, Xiaomei Li, Yuning Wu, Junhong Long, Meihua Tao
BACKGROUND: Despite extensive efforts and advances in evidence-based diabetes management, poor glycaemic control still remains a challenge in many countries. There is a paucity of research addressing the needs of patients with poorly controlled type 2 diabetes, or exploring the effectiveness of empowerment-based interventions in this vulnerable population. OBJECTIVES: To evaluate the effectiveness of a patient-centred, empowerment-based programme on glycaemic control and self-management behaviours among patients with poorly controlled type 2 diabetes...
November 3, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/29149478/hospital-quality-patient-risk-and-medicare-expenditures-for-cancer-surgery
#3
Sarah P Shubeck, Jyothi R Thumma, Justin B Dimick, Hari Nathan
BACKGROUND: Surgical resection is a cornerstone of curative-intent therapy for patients with solid organ malignancies. With increasing attention paid to the costs of surgical care, there is a new focus on variations in the costs of cancer surgery. This study evaluated the potential interactive effect of hospital quality and patient risk on expenditures for cancer resections. METHODS: With 100% Medicare claim data for 2010-2013, patients aged 65 to 99 years who had undergone cancer resection were identified...
November 17, 2017: Cancer
https://www.readbyqxmd.com/read/29149279/impact-of-isolating-clostridium-difficile-carriers-on-the-burden-of-isolation-precautions-a-time-series-analysis
#4
Yasi Xiao, Bianka Paquet-Bolduc, Christophe Garenc, Philippe Gervais, Sylvie Trottier, Jean-François Roussy, Jean Longtin, Vivian G Loo, Yves Longtin
Background: The isolation of asymptomatic Clostridium difficile (CD) carriers may decrease the incidence of hospital-associated C. difficile infections (CDI), but its impact on isolation precaution needs is unknown. Methods: Time series analysis to investigate the impact of isolating CD carriers on the burden of isolation precautions from 2008 to 2016 in a Canadian hospital. To account for the changes in C. difficile infection control policies, the series was divided into three intervention periods...
November 15, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29149151/sacroplasty-a-ten-year-analysis-of-prospective-patients-treated-with-percutaneous-sacroplasty-literature-review-and-technical-considerations
#5
Michael E Frey, Christopher Warner, Samuel M Thomas, Karan Johar, Heathpaul Singh, Maheen S Mohammad, Douglas P Beall
BACKGROUND: The treatment of sacral fractures has evolved since its first description in 1982. Several techniques for sacral augmentation have been developed since 2001, and the rate of improvement is rapid with over 50% reduction in pain achieved prior to post-procedure discharge of the patient. Pain reduction occurs primarily within the first 3 months and is sustained at 12 months; however, the long-term outcomes have not previously been studied. OBJECTIVES: We aim to evaluate the long-term efficacy of sacroplasty versus non-surgical management (NSM) in treating sacral insufficiency fractures (SIFs), including the effect on pain relief, opioid and other analgesic use, patient satisfaction, and complication rates...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29149140/optimization-of-postoperative-intravenous-patient-controlled-analgesia-with-opioid-dexmedetomidine-combinations-an-updated-meta-analysis-with-trial-sequential-analysis-of-randomized-controlled-trials
#6
Ke Peng, Juan Zhang, Xiao-Wen Meng, Hua-Yue Liu, Fu-Hai Ji
BACKGROUND: It is still a challenge to optimize postoperative pain management. The effects of adding dexmedetomidine (DEX) to opioid-based postoperative intravenous patient-controlled analgesia (PCA) are not fully understood. OBJECTIVES: The aim of this study is to assess the efficacy and safety of opioid-DEX combinations for postoperative PCA, and a trial sequential analysis (TSA) is utilized to evaluate the robustness of the current evidence. STUDY DESIGN: A systematic review and meta-analysis...
November 2017: Pain Physician
https://www.readbyqxmd.com/read/29148910/impact-of-pelvic-pain-and-endometriosis-on-patient-reported-outcomes-and-experiences-of-benign-hysterectomy-a-study-from-the-swedish-national-register-for-gynecological-surgery
#7
Hanna Grundström, Siw Alehagen, Carina Berterö, Preben Kjølhede
BACKGROUND: The study objective was to analyze and compare patient-reported experience measures (PREMs) and patient-reported outcome measures (PROMs) after hysterectomy in women with and without a preoperative complaint of pelvic pain associated with and without a confirmed diagnosis of endometriosis. METHODS: Retrospective nationwide register study. Data on 28,776 hysterectomies performed on benign indication between 2004 and 2016 were retrieved from the Swedish National Register for Gynecological Surgery...
November 17, 2017: Journal of Women's Health
https://www.readbyqxmd.com/read/29148905/serum-glucose-potassium-ratio-as-a-clinical-risk-factor-for-aneurysmal-subarachnoid-hemorrhage
#8
Yu Fujiki, Fumihiro Matano, Takayuki Mizunari, Yasuo Murai, Kojiro Tateyama, Kenta Koketsu, Asami Kubota, Shiro Kobayashi, Hiroyuki Yokota, Akio Morita
OBJECTIVE Aneurysmal subarachnoid hemorrhage (SAH) can result in poor outcomes, and biomarkers for predicting poor prognosis have not yet been established. The aim of this study was to clarify the significance of the serum glucose/potassium ratio for predicting the prognosis of aneurysmal SAH. METHODS The authors retrospectively reviewed the records of 565 patients with aneurysmal SAH between 2006 and 2016. The patient group comprised 208 men and 357 women (mean age 61.5 years, range 10-95 years). A statistical analysis was conducted of the clinical and laboratory risk factors of poor outcome, including the serum glucose/potassium ratio...
November 17, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/29148904/randomized-controlled-study-comparing-2-surgical-techniques-for-decompressive-craniectomy-with-watertight-duraplasty-and-without-watertight-duraplasty
#9
Eduardo Vieira, Thiago C Guimarães, Igor V Faquini, Jose L Silva, Tammy Saboia, Rodrigo V C L Andrade, Thaís L Gemir, Valesca C Neri, Nivaldo S Almeida, Hildo R C Azevedo-Filho
OBJECTIVE Decompressive craniectomy (DC) is a widely used procedure in neurosurgery; however, few studies focus on the best surgical technique for the procedure. The authors' objective was to conduct a prospective randomized controlled trial comparing 2 techniques for performing DC: with watertight duraplasty and without watertight duraplasty (rapid-closure DC). METHODS The study population comprised patients ranging in age from 18 to 60 years who were admitted to the Neurotrauma Service of the Hospital da Restauração with a clinical indication for unilateral decompressive craniectomy...
November 17, 2017: Journal of Neurosurgery
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
#10
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/29148332/medicare-advantage-and-traditional-medicare-hospitalization-intensity-and-readmissions
#11
Rachel Mosher Henke, Zeynal Karaca, Teresa B Gibson, Eli Cutler, Marguerite L Barrett, Katharine Levit, Jayne Johann, Lauren Hersch Nicholas, Herbert S Wong
Medicare Advantage plans have incentives and tools to optimize patient care. Therefore, Medicare Advantage hospitalizations may have lower cost and higher quality than similar traditional Medicare hospitalizations. We applied a coarsened matching approach to 2013 Healthcare Cost and Utilization Project hospital discharge data from 22 states to compare hospital cost, length of stay, and readmissions for Traditional Medicare and Medicare Advantage. We found that Medicare Advantage hospitalizations were substantially less expensive and shorter for mental health stays but costlier and longer for injury and surgical stays...
March 1, 2017: Medical Care Research and Review: MCRR
https://www.readbyqxmd.com/read/29148310/biventricular-repair-of-double-outlet-right-ventricle-preoperative-echocardiography-and-surgical-outcomes
#12
Hong Meng, Kun-Jing Pang, Shou-Jun Li, David Hsi, Jun Yan, Sheng-Shou Hu, Zhong-Dong Hua, Hao Wang
OBJECTIVE: To discuss the key anatomic features of double outlet right ventricle (DORV) assessed by preoperative echocardiography among patients treated with different types of biventricular repair. METHODS: Surgical and echocardiographic databases were queried to identify patients who had undergone biventricular repair for DORV and had adequate preoperative echocardiographic imaging. All patients underwent pre- and postoperative echocardiography and clinical evaluation following discharge...
May 2017: World Journal for Pediatric & Congenital Heart Surgery
https://www.readbyqxmd.com/read/29148256/toward-standardization-of-care-the-feeding-readiness-assessment-after-congenital-cardiac-surgery
#13
Daniel E Ehrmann, Matthew Mulvahill, Shaunda Harendt, Jessica Church, Amy Stimmler, Piyagarnt Vichayavilas, Sanja Batz, Jennifer Rodgers, Michael DiMaria, James Jaggers, Cindy Barrett, Jon Kaufman
BACKGROUND: Feeding practices after neonatal and congenital heart surgery are complicated and variable, which may be associated with prolonged hospitalization length of stay (LOS). Systematic assessment of feeding skills after cardiac surgery may earlier identify those likely to have protracted feeding difficulties, which may promote standardization of care. METHODS: Neonates and infants ≤3 months old admitted for their first cardiac surgery were retrospectively identified during a 1-year period at a single center...
November 17, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/29148105/experiences-of-nurse-case-managers-within-a-central-discharge-planning-role-of-collaboration-between-physicians-patients-and-other-healthcare-professionals-a-sociocultural-qualitative-study
#14
Jorun E Thoma, Marion A Waite
AIMS AND OBJECTIVES: Purpose of this study was to gain knowledge of Nurse Case Managers' (NCM) experiences within the German acute care context of collaboration with patients and physicians in a discharge planning role. Further to learn about patients' assignment to the management of the NCMs. Explicitly, to explore critical incidences of interactions between NCM, patients and health care practitioner in discharge planning to understand the factor that contributes to effective collaboration...
November 17, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29147474/new-onset-of-insomnia-in-hospitalized-patients-in-general-medical-wards-incidence-causes-and-resolution-rate
#15
An Ho, Bronson Raja, Richard Waldhorn, Valentina Baez, Idiris Mohammed
Background: Insomnia is common in hospitalized patients. However, no study has examined new onset of insomnia in patients without a prior history of insomnia. Objectives: Incidence of new onset of insomnia in inpatients, associated factors and resolution rate after 2 weeks. Method: This is a prospective observational study conducted at a community hospital. We used the Insomnia Severity Index questionnaire to screen for insomnia in all patients located in the general medical floors from day 3 to day 5 of their hospital stay...
2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29147469/non-pharmacologic-interventions-to-improve-sleep-of-medicine-inpatients-a-controlled-study
#16
Selina Dobing, Anita Dey, Finlay McAlister, Jennifer Ringrose
Background: Sleep quality in hospitalized medicine patients is poor, with environmental factors among the most frequently cited reasons. Objective: We tested the efficacy of a non-pharmacologic intervention on the sleep quality of medicine inpatients. Design/Methods: A controlled study to evaluate our non-pharmacologic multidisciplinary 'TUCK-in' protocol (which includes timed lights-off periods, minimizing night-time noise, distribution of earplugs at bedtime, cued toileting before bedtime, and identification and reduction of modifiable interruptions) was deployed on two of five identical medicine wards...
2017: Journal of Community Hospital Internal Medicine Perspectives
https://www.readbyqxmd.com/read/29147153/successful-aortic-banding-for-type-ia-endoleak-due-to-neck-dilatation-after-endovascular-abdominal-aortic-aneurysm-repair-case-report
#17
Yasushi Tashima, Koichi Tamai, Takehiro Shirasugi, Kenichiro Sato, Takahiro Yamamoto, Yusuke Imamura, Atsushi Yamaguchi, Hideo Adachi, Toshiyuki Kobinata
A 69-year-old man with a type IA endoleak that developed approximately 21 months after endovascular abdominal aortic aneurysm repair (EVAR) of a 46 mm diameter aneurysm was referred to our department. He had impaired renal function, Parkinson's disease, and previous cerebral infarction. Computed tomography angiography showed a type IA endoleak with neck dilatation and that the aneurysm had grown to 60 mm in diameter. We decided to perform aortic banding. The type IA endoleak disappeared after banding and the patient was discharged on postoperative day 10...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29147152/pulmonary-stenosis-caused-by-ductus-arteriosus-aneurysm-a-case-report
#18
Yasushi Tashima, Naoyuki Kimura, Koichi Tamai, Kenichiro Sato, Koichi Yuri, Harunobu Matsumoto, Atsushi Yamaguchi, Hideo Adachi, Toshiyuki Kobinata
A 76-year-old woman with a 2-week history of dyspnea on exertion was admitted to our hospital. A computed tomography scan showed a 70-mm diameter aortic arch aneurysm containing a large thrombus that was compressing the pulmonary artery. Echocardiography showed severe pulmonary stenosis and no shunt flow. Operative findings revealed an aneurysmal thrombus protruding into the lumen of the pulmonary artery through a foramen. A ductus arteriosus aneurysm was diagnosed. After the thrombus removal, arch replacement and ductus closure with a prosthetic patch were performed...
September 25, 2017: Annals of Vascular Diseases
https://www.readbyqxmd.com/read/29146873/mobile-interventional-stroke-teams-lead-to-faster-treatment-times-for-thrombectomy-in-large-vessel-occlusion
#19
Daniel Wei, Thomas J Oxley, Dominic A Nistal, Justin R Mascitelli, Natalie Wilson, Laura Stein, John Liang, Lena M Turkheimer, Jacob R Morey, Claire Schwegel, Ahmed J Awad, Hazem Shoirah, Christopher P Kellner, Reade A De Leacy, Stephan A Mayer, Stanley Tuhrim, Srinivasan Paramasivam, J Mocco, Johanna T Fifi
BACKGROUND AND PURPOSE: Endovascular recanalization treatment for acute ischemic stroke is a complex, time-sensitive intervention. Trip-and-treat is an interhospital service delivery model that has not previously been evaluated in the literature and consists of a shared mobile interventional stroke team that travels to primary stroke centers to provide on-site interventional capability. We compared treatment times between the trip-and-treat model and the traditional drip-and-ship model...
November 16, 2017: Stroke; a Journal of Cerebral Circulation
https://www.readbyqxmd.com/read/29146681/a-qualitative-study-of-patient-involvement-in-medicines-management-after-hospital-discharge-an-under-recognised-source-of-systems-resilience
#20
Beth Fylan, Gerry Armitage, Deirdre Naylor, Alison Blenkinsopp
INTRODUCTION: There are risks to the safety of medicines management when patient care is transferred between healthcare organisations, for example, when a patient is discharged from hospital. Using the theoretical concept of resilience in healthcare, this study aimed to better understand the proactive role that patients can play in creating safer, resilient medicines management at a common transition of care. METHODS: Qualitative interviews with 60 cardiology patients 6 weeks after their discharge from 2 UK hospitals explored patients' experiences with their discharge medicines...
November 16, 2017: BMJ Quality & Safety
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