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https://www.readbyqxmd.com/read/28428755/pharmacological-analysis-of-the-anti-epileptic-mechanisms-of-fenfluramine-in-scn1a-mutant-zebrafish
#1
Jo Sourbron, Ilse Smolders, Peter de Witte, Lieven Lagae
Dravet syndrome (DS) is a genetic encephalopathy that is characterized by severe seizures and prominent co-morbidities (e.g., physical, intellectual disabilities). More than 85% of the DS patients carry an SCN1A mutation (sodium channel, voltage gated, type I alpha subunit). Although numerous anti-epileptic drugs have entered the market since 1990, these drugs often fail to adequately control seizures in DS patients. Nonetheless, current clinical data shows significant seizure reduction in DS patients treated with the serotonergic (5-hydroxytryptamine, 5-HT) drug fenfluramine (FA)...
2017: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/28423783/automated-diagnosis-coding-with-combined-text-representations
#2
Stefan Berndorfer, Aron Henriksson
Automated diagnosis coding can be provided efficiently by learning predictive models from historical data; however, discriminating between thousands of codes while allowing a variable number of codes to be assigned is extremely difficult. Here, we explore various text representations and classification models for assigning ICD-9 codes to discharge summaries in MIMIC-III. It is shown that the relative effectiveness of the investigated representations depends on the frequency of the diagnosis code under consideration and that the best performance is obtained by combining models built using different representations...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28400898/many-neurology-readmissions-are-nonpreventable
#3
Sidney T Le, S Andrew Josephson, Hans A Puttgen, Lorrie Gibson, Elan L Guterman, Heather M Leicester, Carla L Graf, John C Probasco
INTRODUCTION: Reducing unplanned hospital readmissions has become a national focus due to the Centers for Medicare and Medicaid Services' (CMS) penalties for hospitals with high rates. A first step in reducing unplanned readmission is to understand which patients are at high risk for readmission, which readmissions are planned, and how well planned readmissions are currently captured in comparison to patient-level chart review. METHODS: We examined all 5455 inpatient neurology admissions over a 2-year period to University of California San Francisco Medical Center and Johns Hopkins Hospital via chart review...
April 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28398701/cervical-pessary-for-preventing-preterm-birth-in-singleton-pregnancies-with-short-cervical-length-a-systematic-review-and-meta-analysis
#4
Gabriele Saccone, Andrea Ciardulli, Serena Xodo, Lorraine Dugoff, Jack Ludmir, Giorgio Pagani, Silvia Visentin, Salvatore Gizzo, Nicola Volpe, Giuseppe Maria Maruotti, Giuseppe Rizzo, Pasquale Martinelli, Vincenzo Berghella
OBJECTIVES: To evaluate the effectiveness of cervical pessary for preventing spontaneous preterm birth (SPTB) in singleton gestations with a second trimester short cervix. METHODS: Electronic databases were searched from their inception until February 2016. We included randomized clinical trials (RCTs) comparing the use of the cervical pessary with expectant management in singletons pregnancies with transvaginal ultrasound cervical length (TVU CL) ≤25 mm. The primary outcome was incidence of SPTB <34 weeks...
April 11, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28396173/contribution-of-alcohol-use-disorders-on-the-burden-of-chronic-hepatitis-c-in-france-2008-2013-a-nationwide-retrospective-cohort-study
#5
Michaël Schwarzinger, Sylvain Baillot, Prof Yazdan Yazdanpanah, Prof Jürgen Rehm, Vincent Mallet
BACKGROUND AND AIMS: Hepatitis C virus (HCV) patients are at risk of alcohol use disorders (AUDs). We measured the contribution of AUDs on the burden of chronic HCV infection in French HCV patients. METHODS: We tracked the hospital trajectory of 97,347 French HCV patients aged 18-65 in January 2008 and followed until in-hospital death or December 2013. Primary outcome was the frequency of liver-related complications. Secondary outcomes were the frequency of liver transplantation and otherwise cause-specific mortality...
April 7, 2017: Journal of Hepatology
https://www.readbyqxmd.com/read/28375815/maryland-s-medical-orders-for-life-sustaining-treatment-form-use-reports-of-a-statewide-survey
#6
Anita J Tarzian, Nadia B Cheevers
BACKGROUND: Advance directives (ADs) and Physicians Orders for Life-Sustaining Treatment (POLST) orders perform different but complementary functions in documenting a patient's treatment preferences and translating them into actionable orders that change in keeping with the patient's evolving clinical picture. Maryland's Medical Orders for Life-Sustaining Treatment (MOLST) form developed through a stakeholder-driven process that deviates from other POLST forms. While a patient or surrogate can decline discussing MOLST orders with a clinician, clinicians must write MOLST orders for certain patients (e...
April 4, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28370904/repeat-prescribing-of-medications-a-system-centred-risk-management-model-for-primary-care-organisations
#7
Julie Price, Shu Ling Man, Stephen Bartlett, Kate Taylor, Mark Dinwoodie, Paul Bowie
RATIONALE, AIMS AND OBJECTIVES: Reducing preventable harm from repeat medication prescriptions is a patient safety priority worldwide. In the United Kingdom, repeat prescriptions items issued has doubled in the last 20 years from 5.8 to 13.3 items per patient per annum. This has significant resource implications and consequences for avoidable patient harms. Consequently, we aimed to test a risk management model to identify, measure, and reduce repeat prescribing system risks in primary care...
March 31, 2017: Journal of Evaluation in Clinical Practice
https://www.readbyqxmd.com/read/28359288/termination-of-prehospital-resuscitative-efforts-a-study-of-documentation-on-ethical-considerations-at-the-scene
#8
Søren Mikkelsen, Caroline Schaffalitzky de Muckadell, Lars Grassmé Binderup, Hans Morten Lossius, Palle Toft, Annmarie Touborg Lassen
BACKGROUND: Discussions on ethical aspects of life-and-death decisions within the hospital are often made in plenary. The prehospital physician, however, may be faced with ethical dilemmas in life-and-death decisions when time-critical decisions to initiate or refrain from resuscitative efforts need to be taken without the possibility to discuss matters with colleagues. Little is known whether these considerations regarding ethical issues in crucial life-and-death decisions are documented prehospitally...
March 31, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28341427/community-onset-carbapenem-resistant-klebsiella-pneumoniae-urinary-tract-infections-in-infancy-following-nicu-hospitalisation
#9
Eleni Vergadi, Maria Bitsori, Sofia Maraki, Emmanouil Galanakis
INTRODUCTION: Urinary tract infection (UTI) is a common bacterial infection in childhood with favourable outcome. However, the recent emergence of UTI caused by multidrug-resistant pathogens, such as carbapenem-resistant Enterobacteriaceae (CRE), has become a great concern worldwide. CRE are mainly responsible for nosocomial infections and community-onset CRE infections in healthy individuals are rare. OBJECTIVES: In this study, we report a series of infants without substantial genitourinary abnormalities that were admitted with community-onset urinary tract infections (UTIs) caused by carbapenem-resistant Klebsiella pneumoniae (CRKP) and we discuss their aetiology...
March 11, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28334559/design-and-hospitalwide-implementation-of-a-standardized-discharge-summary-in-an-electronic-health-record
#10
Shannon M Dean, Andrea Gilmore-Bykovskyi, Joel Buchanan, Brad Ehlenfeldt, Amy J H Kind
BACKGROUND: The hospital discharge summary is the primary method used to communicate a patient's plan of care to the next provider(s). Despite the existence of regulations and guidelines outlining the optimal content for the discharge summary and its importance in facilitating an effective transition to posthospital care, incomplete discharge summaries remain a common problem that may contribute to poor posthospital outcomes. Electronic health records (EHRs) are regularly used as a platform on which standardization of content and format can be implemented...
December 2016: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28333814/committee-opinion-no-694-summary-management-of-mesh-and-graft-complications-in-gynecologic-surgery
#11
(no author information available yet)
This document focuses on the management of complications related to mesh used to correct stress urinary incontinence or pelvic organ prolapse. Persistent vaginal bleeding, vaginal discharge, or recurrent urinary tract infections after mesh placement should prompt an examination and possible further evaluation for exposure or erosion. A careful history and physical examination is essential in the diagnosis of mesh and graft complications. A clear understanding of the location and extent of mesh placement, as well as the patient's symptoms and therapy goals, are necessary to plan treatment approaches...
April 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28304316/perspectives-and-attitudes-of-pediatricians-concerning-post-discharge-care-practice-of-premature-infants
#12
A Gad, E Parkinson, N Khawar, A Elmeki, P Narula, D Hoang
OBJECTIVE: Survival rates of premature infants are at a historical high and increasingly more pediatricians are caring for former premature infants. The goal of this study was to describe the perspectives and attitudes of pediatricians, as well as, the challenges of rendering post-neonatal intensive care unit (NICU) discharge care for premature infants. METHODS: An anonymous 22-question web-based survey was emailed to pediatricians who are current members of the American Academy of Pediatrics (AAP) and practicing in Kings County, New York...
March 16, 2017: Journal of Neonatal-perinatal Medicine
https://www.readbyqxmd.com/read/28303578/compulsory-community-and-involuntary-outpatient-treatment-for-people-with-severe-mental-disorders
#13
REVIEW
Steve R Kisely, Leslie A Campbell, Richard O'Reilly
BACKGROUND: It is controversial whether compulsory community treatment (CCT) for people with severe mental illness (SMI) reduces health service use, or improves clinical outcome and social functioning. OBJECTIVES: To examine the effectiveness of compulsory community treatment (CCT) for people with severe mental illness (SMI). SEARCH METHODS: We searched the Cochrane Schizophrenia Group's Study-Based Register of Trials (2003, 2008, 2012, 8 November 2013, 3 June 2016)...
March 17, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28302323/new-onset-diabetes-after-acute-and-critical-illness-a-systematic-review
#14
REVIEW
Chirag J Jivanji, Varsha M Asrani, John A Windsor, Maxim S Petrov
Hyperglycemia is commonly observed during acute and critical illness. Recent studies have investigated the risk of developing diabetes after acute and critical illness, but the relationship between degree of in-hospital hyperglycemia and new-onset diabetes has not been investigated. This study examines the evidence for the relationship between in-hospital hyperglycemia and prevalence of new-onset diabetes after acute and critical illness. A literature search was performed of the MEDLINE, EMBASE, and Scopus databases for relevant studies published from January 1, 2000, through August 4, 2016...
March 13, 2017: Mayo Clinic Proceedings
https://www.readbyqxmd.com/read/28300480/impossible-decision-an-investigation-of-risk-trade-offs-in-the-intensive-care-unit
#15
Tom W Reader, Geetha Reddy, Stephen J Brett
In the intensive care unit (ICU), clinicians must often make risk trade-offs on patient care. For example, on deciding whether to discharge a patient before they have fully recovered in order to create a bed for another, sicker, patient. When misjudged, these decisions can negatively influence patient outcomes: yet it can be difficult, if not impossible, for clinicians to evaluate with certainty the safest course of action. Using a vignette-based interview methodology, a naturalistic decision-making approach was utilised to study this phenomena...
March 16, 2017: Ergonomics
https://www.readbyqxmd.com/read/28285390/improving-communication-of-medication-changes-using-a-pharmacist-prepared-discharge-medication-management-summary
#16
Choon Ean Ooi, Olivia Rofe, Michelle Vienet, Rohan A Elliott
Background Discontinuity of care between hospital and primary care is often due to poor information transfer. Medication information in medical discharge summaries (DS) is often incomplete or incorrect. The effectiveness and feasibility of hospital pharmacists communicating medication information, including changes made in the hospital, is not clearly defined. Objective To explore the impact of a pharmacist-prepared Discharge Medication Management Summary (DMMS) on the accuracy of information about medication changes provided to patients' general practitioners (GPs)...
March 11, 2017: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/28282907/complications-from-surgeries-related-to-ovarian-cancer-screening
#17
Lauren A Baldwin, Edward J Pavlik, Emma Ueland, Hannah E Brown, Kelsey M Ladd, Bin Huang, Christopher P DeSimone, John R van Nagell, Frederick R Ueland, Rachel W Miller
The aim of this study was to evaluate complications of surgical intervention for participants in the Kentucky Ovarian Cancer Screening Program and compare results to those of the Prostate, Lung, Colorectal and Ovarian Cancer Screening trial. A retrospective database review included 657 patients who underwent surgery for a positive screen in the Kentucky Ovarian Cancer Screening Program from 1988-2014. Data were abstracted from operative reports, discharge summaries, and office notes for 406 patients. Another 142 patients with incomplete records were interviewed by phone...
March 8, 2017: Diagnostics
https://www.readbyqxmd.com/read/28272593/the-unmet-need-for-postacute-rehabilitation-among-medicare-observation-patients-a-single-center-study
#18
Jennifer N Goldstein, J Sanford Schwartz, Patricia McGraw, Tobias L Banks, LeRoi S Hicks
BACKGROUND: Medicare beneficiaries admitted under observation status must pay for postacute inpatient rehabilitation (PAIR) services, out of pocket, at potentially prohibitive costs. OBJECTIVE: To determine if there is an unmet need for PAIR among Medicare observation patients and if this care is associated with longer hospital stay and increased rehospitalization. DESIGN/SETTING: Observational study using electronic medical record and administrative data from a regional health system...
March 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28272242/predictive-factors-and-clinical-practice-profile-for-strictures-post-necrotising-enterocolitis
#19
MULTICENTER STUDY
Han Zhang, Jiaping Chen, Yan Wang, Chun Deng, Lei Li, Chunbao Guo
Intestinal stricture is a severe and common complication of necrotizing enterocolitis (NEC), causing severe and prolonged morbidity. Our goal was to investigate the clinical predictors for strictures developing after NEC and evaluate the management outcome of the post-NEC strictures to better orient their medicosurgical care.A total of 188 patients diagnosed with NEC with identical treatment protocols throughout the period under study were retrospectively reviewed from 4 academic neonatal centers between from January 1, 2011, and October 31, 2016...
March 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28266259/-burden-and-rehabilitation-goals-of-families-in-pediatric-oncological-rehabilitation
#20
Laura Inhestern, Volker Beierlein, Konstantin A Krauth, Thomas Schulte, Dieter Berger, Uwe Koch, Corinna Bergelt
Burden and Rehabilitation Goals of Families in Pediatric-oncological Rehabilitation Survival rates of childhood cancer patients increased during the past years up to 80 %. Therefore, pediatric oncological rehabilitation is essential for reintegrating children with cancer into normal life. We performed an analysis of the current state in pediatric oncological rehabilitation with regards to the impairments of the participants and results in rehabilitation. Descriptive and content analyses of 422 medical discharge summaries were conducted...
March 2017: Praxis der Kinderpsychologie und Kinderpsychiatrie
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