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https://www.readbyqxmd.com/read/28738364/risk-factors-for-community-acquired-pneumonia-in-adults-a-systematic-review-of-observational-studies
#1
Jordi Almirall, Mateu Serra-Prat, Ignasi Bolíbar, Valentina Balasso
We performed a systematic review of the literature to establish conclusive evidence of risk factors for community-acquired pneumonia (CAP). Observational studies (cross-sectional, case-control, and cohort studies) the primary outcome of which was to assess risk factors for CAP in both hospitalized and ambulatory adult patients with radiologically confirmed pneumonia were selected. The Newcastle-Ottawa Scale specific for cohort and case-control designs was used for quality assessment. Twenty-nine studies (20 case-control, 8 cohort, and 1 cross-sectional) were selected, with 44...
July 25, 2017: Respiration; International Review of Thoracic Diseases
https://www.readbyqxmd.com/read/28738296/mental-distress-quality-of-life-and-social-support-in-recurrent-ovarian-cancer-patients-during-active-chemotherapy
#2
Qiang Wen, Zhuyan Shao, Ping Zhang, Tao Zhu, Dan Li, Shihua Wang
BACKGROUND: Anxiety and depression are common sources of mental distress experienced by ovarian cancer patients. The purpose of this study was to identify changes in levels of mental distress during active chemotherapy, to characterize the impact of these changes on quality of life (QOL), and to study the potential buffering effect of social support in recurrent ovarian cancer patients. METHODS: Anxiety and depression were assessed at baseline and three months after initiation of active chemotherapy using hospital anxiety and depression scale (HADS)...
July 6, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/28737996/integrating-palliative-and-oncology-care-for-patients-with-advanced-cancer-a-quality-improvement-intervention
#3
Laura C Hanson, Frances Collichio, Stephen A Bernard, William A Wood, Matt Milowsky, Erin Burgess, Crista J Creedle, Summer Cheek, Lydia Chang, Bhisham Chera, Alexandra Fox, Feng-Chang Lin
BACKGROUND: Practice guidelines recommend palliative care for patients with advanced cancer, but gaps in access and quality of care persist. OBJECTIVE: To increase goals-of-care (GOC) communication for hospitalized patients with Stage IV cancer. METHODS: An interdisciplinary team designed a quality improvement intervention to enhance oncology palliative care, including training in communication skills and triggers for palliative care consults...
July 24, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28737951/monitoring-of-small-bowel-crohn-s-disease
#4
Uri Kopylov, Anastasios Koulaouzidis, Eyal Klang, Dan Carter, Shomron Ben-Horin, Rami Eliakim
In recent years, the therapeutic paradigm in Crohn's disease has shifted from a mere symptom-oriented approach, to aiming to healing of the underlying inflammation and prevention of long-term structural complications. Such "treat-to-target" approach may allow for a more stable disease course with less hospitalizations, lower requirement for surgery and improved quality of life. In Crohn's disease, the small bowel is affected in the majority of patients; frequently, Crohn's involves only the small bowel, which remains inaccessible to conventional ileocolonoscopic techniques...
July 24, 2017: Expert Review of Gastroenterology & Hepatology
https://www.readbyqxmd.com/read/28737647/risk-factors-for-30-day-hospital-readmission-for-diverticular-hemorrhage
#5
Jonah N Rubin, Daniel Shoag, John N Gaetano, Dejan Micic, Neil Sengupta
INTRODUCTION: The 2010 Affordable Care Act introduced the Hospital Readmissions Reduction Program to reduce health care utilization. Diverticular disease and its complications remain a leading cause of hospitalization among gastrointestinal disease. We sought to determine risk factors for 30-day hospital readmissions after hospitalization for diverticular bleeding. MATERIALS AND METHODS: We utilized the 2013 National Readmission Database sponsored by the Agency for Healthcare Research and Quality focusing on hospitalizations with the primary or secondary discharge diagnosis of diverticular hemorrhage or diverticulitis with hemorrhage...
July 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28737600/an-interprofessional-quality-improvement-initiative-to-standardize-pediatric-extubation-readiness-assessment
#6
Samer Abu-Sultaneh, Acrista J Hole, Alvaro J Tori, Brain D Benneyworth, Riad Lutfi, Christopher W Mastropietro
OBJECTIVES: Establishing protocols to wean mechanical ventilation and assess readiness for extubation, with the goal of minimizing morbidity associated with extubation failure and prolonged mechanical ventilation, have become increasingly important in contemporary PICUs. The aim of this quality improvement initiative is to establish a respiratory therapist-led daily spontaneous breathing trial protocol to standardize extubation readiness assessment and documentation in our PICU. DESIGN: A quality improvement project...
July 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28737598/epidemiology-and-outcomes-of-cardiac-arrest-in-pediatric-cardiac-icus
#7
Jeffrey A Alten, Darren Klugman, Tia T Raymond, David S Cooper, Janet E Donohue, Wenying Zhang, Sara K Pasquali, Michael G Gaies
OBJECTIVES: In-hospital cardiac arrest occurs in 2.6-6% of children with cardiac disease and is associated with significant morbidity and mortality. Much remains unknown about cardiac arrest in pediatric cardiac ICUs; therefore, we aimed to describe cardiac arrest epidemiology in a contemporary multicenter cardiac ICU cohort. DESIGN: Retrospective analysis within the Pediatric Cardiac Critical Care Consortium clinical registry. SETTING: Cardiac ICUs within 23 North American hospitals...
July 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28737547/quality-improvement-initiative-for-family-centered-care-in-the-neonatal-intensive-care-unit-of-a-tertiary-hospital-in-south-africa
#8
Carin Maree, Poppy Kekana, Christa van der Walt, Mariatha Yazbek, Ronell Leech
The introduction of family-centered care in the neonatal intensive care unit was identified as a high priority to facilitate bonding and attachment with potential positive outcomes for the parents and infants. The aim of the study was, therefore, to develop and implement a quality improvement initiative to foster family-centered care in a tertiary neonatal intensive care unit from birth onward. A pretest posttest intervention design was used using mixed methods over 3 phases to determine the perceived level of family-centered care according to healthcare professionals and parents using self-administered questionnaires; to develop and implement a quality improvement initiative to enhance family-centered care in a neonatal intensive care unit using a nominal group technique, followed by the quality improvement process; and to evaluate the outcomes of the initiative by repeating the self-administered questionnaires to parents and staff...
July 2017: Journal of Perinatal & Neonatal Nursing
https://www.readbyqxmd.com/read/28737270/hospital-ownership-status-and-cesareans-in-the-united-states-the-effect-of-for-profit-hospitals
#9
Theresa Morris, Kelly McNamara, Christine H Morton
BACKGROUND: Given the increasing proportion of United States hospitals that are for-profit, we examined whether women who give birth in for-profit hospitals are more likely to have cesareans than women who give birth in not-for-profit hospitals. We hypothesized that cesareans are more likely to occur in for-profit hospitals because of the organizational emphasis on short-term financial indicators, including payment of shareholder dividends. METHODS: We used logistic regression and difference of means tests to analyze data from the Listening to Mothers III survey of women who gave birth in the United States in 2011 and 2012...
July 24, 2017: Birth
https://www.readbyqxmd.com/read/28736862/quality-management-of-ultrasound-surveillance-for-hepatocellular-carcinoma-under-the-korean-national-cancer-screening-program
#10
Moon Hyung Choi, Seung Eun Jung, Joon-Il Choi, Woo Kyoung Jeong, Hyun Cheol Kim, Yongsoo Kim, Yeol Kim, Boyoung Park
OBJECTIVES: The aim of this study was to investigate the quality of ultrasound (US) examinations for hepatocellular carcinoma surveillance under the Korean National Cancer Screening Program and to assess knowledge and experience about liver US of physicians who perform US examinations. METHODS: The investigation about the quality of liver US for hepatocellular carcinoma screening was based on the results of a nationwide quality assurance (QA) evaluation between 2012 and 2014 at all medical institutions participating in the National Cancer Screening Program...
July 24, 2017: Journal of Ultrasound in Medicine: Official Journal of the American Institute of Ultrasound in Medicine
https://www.readbyqxmd.com/read/28736384/-revisional-surgery-for-nonstandard-gastric-bypass-a-case-report
#11
Yu Gao, Zhi-Gang Ke, Jian-Guo Liu, Wei-Dong Tong
Bariatric surgery is the most effective treatment for obesity with or without type 2 diabetes mellitus and its complications. With the growing incidence of type 2 diabetes mellitus, the number of hospitals performing bariatric surgery and surgical cases increase substantially. The problems in operation standardization, quality control of operation and postoperative management of the patients cause the failure in weight loss, hypoglycemia and severe complications, and revisional surgery is often required to correct the condition...
July 20, 2017: Nan Fang Yi Ke da Xue Xue Bao, Journal of Southern Medical University
https://www.readbyqxmd.com/read/28736131/variation-in-organization-of-transient-ischemic-attack-care-in-the-netherlands-a-nationwide-survey-study
#12
Fenna Floortje Muller, Frank de Beer, Marieke Christine Visser
BACKGROUND: Previous research has shown the importance of urgent initiation of antiplatelet therapy after transient ischemic attack (TIA) to reduce the risk of stroke. Many hospitals in the Netherlands have therefore implemented rapid pathways for assessment of patients with TIA. Dutch stroke guidelines lack clear directives for organization of TIA assessment and thus allow for variation. The aim of this study was to investigate variation in organization of TIA assessment in Dutch hospitals...
July 20, 2017: Journal of Stroke and Cerebrovascular Diseases: the Official Journal of National Stroke Association
https://www.readbyqxmd.com/read/28736060/subtotal-vs-total-parathyroidectomy-with-autotransplantation-for-patients-with-renal-hyperparathyroidism-have-similar-outcomes
#13
Kevin Anderson, Ewa Ruel, Mohamed A Adam, Samantha Thomas, Linda Youngwirth, Michael T Stang, Randall P Scheri, Sanziana A Roman, Julie A Sosa
BACKGROUND: The optimal surgery for patients with renal hyperparathyroidism has been controversial, as either subtotal parathyroidectomy (subtotal PTX) or total parathyroidectomy with auto-transplantation (total PTX-AT) may be employed. METHODS: Adult patients having subtotal PTX or total PTX-AT for secondary hyperparathyroidism were identified from the American College of Surgeons National Surgical Quality Improvement Program, 2005-2013. RESULTS: Of 1130 patients, the majority (n = 765, 68%) underwent subtotal PTX...
July 17, 2017: American Journal of Surgery
https://www.readbyqxmd.com/read/28735828/investigation-of-dietary-supplements-prevalence-as-complementary-therapy-comparison-between-hospitalized-psoriasis-patients-and-non-psoriasis-patients-correlation-with-disease-severity-and-quality-of-life
#14
Hadis Yousefzadeh, Mahmoud Mahmoudi, Mahnaz Banihashemi, Maryam Rastin, Farahzad Jabbari Azad
OBJECTIVES: Psoriasis patients are often displeased with traditional medical treatments and they may self-prescribe dietary supplements as an alternative or complementary treatments. We aimed to investigate the prevalence of self-medication of dietary supplements among psoriasis and non-psoriasis cases and its impact on disease severity and quality of life. DESIGN AND SETTING: This case-control study evaluated 252 records of psoriasis patients and 245 non-psoriasis cases...
August 2017: Complementary Therapies in Medicine
https://www.readbyqxmd.com/read/28735811/improving-hospital-quality-to-reduce-disparities-in-severe-maternal-morbidity-and-mortality
#15
Elizabeth A Howell, Jennifer Zeitlin
Significant racial/ethnic disparities in maternal morbidity and mortality exist in the United States. Black women are 3-4 times more likely to die a pregnancy-related death as compared with white women. Growing research suggests that hospital quality may be a critical lever for improving outcomes and narrowing disparities. This overview reviews the evidence demonstrating that hospital quality is related to maternal mortality and morbidity, discusses the pathways through which these associations between quality and severe maternal morbidity generate disparities, and concludes with a discussion of possible levers for action to reduce disparities by improving hospital quality...
July 20, 2017: Seminars in Perinatology
https://www.readbyqxmd.com/read/28735722/-is-the-introduction-of-clinical-management-programs-for-patients-with-chronic-obstructive-pulmonary-disease-useful-comparison-of-the-effectiveness-of-two-interventions-on-the-clinical-progress-and-care-received
#16
Ingrid Solanes, Ignasi Bolíbar, Maria Antònia Llauger, Meritxell Peiro, Pepi Valverde, Mar Fraga, Casimira Medrano, Teresa Bigorra, Montserrat Freixas, Iskra Ligüerre, Maria Antònia Pou, Leandra Domínguez, Carles Valero, Judit Solà, Jordi Giner, Vicente Plaza
OBJECTIVE: To evaluate the effectiveness of two management programs on patients with chronic obstructive pulmonary disease (COPD). DESIGN: A study with a quasi-experimental design was used to evaluate the effectiveness of two interventions (I1, I2) for the care of patients with COPD after a mean follow-up of 31.2months. SETTING: Primary Care Centres in two Barcelona Health Areas and their referral hospitals. PARTICIPANTS: Patients with COPD selected by simple random sampling using any disease code corresponding to COPD...
July 20, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28735551/quality-of-pharmacist-managed-anticoagulation-therapy-in-long-term-ambulatory-settings-a-systematic-review
#17
Beenish S Manzoor, Wei-Han Cheng, James C Lee, Ellen M Uppuluri, Edith A Nutescu
OBJECTIVE: To perform a systematic review to evaluate the quality of warfarin anticoagulation control in outpatient pharmacist-managed anticoagulation services (PMAS) compared with routine medical care (RMC). DATA SOURCES: MEDLINE, SCOPUS, EMBASE, IPA, CINAHL, and Cochrane CENTRAL, from inception to May 2017. Search terms employed: ("pharmacist-managed" OR "pharmacist-provided" OR "pharmacist-led" OR "pharmacist-directed") AND ("anticoagulation services" OR "anticoagulation clinic" OR "anticoagulation management" OR "anticoagulant care") AND ("quality of care" OR "outcomes" OR "bleeding" OR "thromboembolism" OR "mortality" OR "hospitalization" OR "length of stay" OR "emergency department visit" OR "cost" OR "patient satisfaction")...
July 1, 2017: Annals of Pharmacotherapy
https://www.readbyqxmd.com/read/28735331/evaluation-of-the-levels-and-quality-of-microbial-contamination-in-medical-emergency-departments-in-comparison-to-other-workplaces
#18
Agata Bielawska-Drózd, Bożena Wlizło-Skowronek, Piotr Cieślik, Izabela Winnicka, Ewa Skopińska-Różewska, Leszek Kubiak, Dorota Żakowska, Aleksandra Brewczyńska, Janusz Kocik
Work in Hospital Emergency Departments (HEDs) exposes both the emergency ward staff and patients to infectious and in other way harmful biological agents. The results of this study shows the presence of pathogenic bacteria isolated by three different methods. It revealed 9.8% of pathogens detected by imprint method, 10.5% of pathogens by swabbing method, 17.6% and 22% in HEDs corridors and rooms, respectively, by air sampling method. In control workplaces (offices) pathogenic bacteria reached the level of 6...
January 2, 2017: Polish Journal of Microbiology
https://www.readbyqxmd.com/read/28735269/patient-family-agreement-on-values-and-preferences-for-life-sustaining-treatment-results-of-a-multicentre-observational-study
#19
Amane Abdul-Razzak, Daren K Heyland, Jessica Simon, Sunita Ghosh, Andrew G Day, John J You
OBJECTIVES: To quantify agreement between patients and their family members on their own values and preferences for use or non-use of life-sustaining treatments for the patient. METHODS: Hospitalised patients aged 55 years or older with advanced pulmonary, cardiac, liver disease or metastatic cancer or aged 80 years or older from medical wards at 16 Canadian hospitals and their family members completed a questionnaire including eight items about values related to life-sustaining treatment and a question about preferences for life-sustaining treatments...
July 22, 2017: BMJ Supportive & Palliative Care
https://www.readbyqxmd.com/read/28735120/outpatient-lumbar-microdiscectomy-in-france-from-an-economic-imperative-to-a-clinical-standard-an-observational-study-of-201-cases
#20
Bertrand Debono, Pascal Sabatier, Valérie Garnault, Olivier Hamel, Philippe Bousquet, Jean-Paul Lescure, Jean-Yves Plas
PURPOSE: The outpatient lumbar discectomy procedures have been established for more than two decades. However, especially in Europe, there are still obstacles to the development of these procedures, which may be related to medico-economic imperatives, and to several factors concerning both surgeons and patients. We describe our initial experience in introducing this method in our institution. METHODS: Over a three year period, 201 patients met the criteria for ambulatory lumbar microdiscectomy...
July 19, 2017: World Neurosurgery
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