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Post-acute care

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https://www.readbyqxmd.com/read/28551929/-early-in-hospital-mortality-in-internal-medicine-wards-within-24-hours-a-potential-quality-indicator-or-a-variable-affected-by-multiple-factors
#1
Yaron Niv, Evgeny Berkov, Pazit Kanter, Evgeny Abrahmson, Uri Gabbay
AIMS: To evaluate in-hospital mortality rate within 24 hours in internal medicine wards and to evaluate if it may be used as quality indicator. BACKGROUND: In-hospital mortality rate is an outcome measure which apparently reflects quality of care. There are debates on whether it may be considered a quality indicator since it is difficult to compare different case-mixes between hospitals. Research on mortality within 24 hours had not been published. METHODS: An historical prospective study was conducted including the entire internal wards admissions to the Rabin Medical Center between 1/7/14 and 30/6/15...
April 2017: Harefuah
https://www.readbyqxmd.com/read/28551043/improving-transitions-to-post-acute-care-for-elderly-patients-using-a-novel-video-conferencing-program-echo-care-transitions
#2
Amber B Moore, J Elyse Krupp, Alyssa B Dufour, Mousumi Sircar, Thomas G Travison, Alan Abrams, Grace Farris, Melissa L P Mattison, Lewis A Lipsitz
PURPOSE: Within 30 days of hospital discharge to a skilled nursing facility, older adults are at high risk for death, re-hospitalization and high-cost healthcare. The purpose of this study was to examine whether a novel videoconference program called Extension for Community Health Outcomes-Care Transitions (ECHO-CT) that connects an interdisciplinary hospital-based team with clinicians at skilled nursing facilities, reduces patient mortality, hospital readmission, skilled nursing facility length of stay and 30-day health care costs...
May 24, 2017: American Journal of Medicine
https://www.readbyqxmd.com/read/28550403/healthcare-utilization-and-costs-in-ards-survivors-a-1-year-longitudinal-national-us-multicenter-study
#3
A Parker Ruhl, Minxuan Huang, Elizabeth Colantuoni, Taruja Karmarkar, Victor D Dinglas, Ramona O Hopkins, Dale M Needham
PURPOSE: To evaluate (1) post-discharge healthcare utilization and estimated costs in ARDS survivors, and (2) the association between patient and intensive care-related variables, and 6-month patient status, with subsequent hospitalization and costs. METHODS: Longitudinal cohort study enrolling from four ARDSNet trials in 44 US hospitals. Healthcare utilization was collected via structured interviews at 6 and 12 months post-ARDS, and hospital costs estimated via the Medical Expenditure Panel Survey...
May 26, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28549708/chronic-obstructive-pulmonary-disease-in-post-acute-long-term-care-settings-seizing-opportunities-to-individualize-treatment-and-device-selection
#4
Meenakshi Patel, Karl Steinberg, Manuel Suarez-Barcelo, Dana Saffel, Rick Foley, Chad Worz
INTRODUCTION: The burden of chronic obstructive pulmonary disease (COPD) in post-acute/long-term care (PA/LTC) settings is high, and many patients do not receive guideline-recommended care. METHODS: An interprofessional expert panel of PA/LTC professionals convened to discuss the unmet medical needs in patients with COPD in PA/LTC settings, and to make recommendations for the assessment of COPD patients to individualize the selection of maintenance treatment. RESULTS: Unmet needs observed in patients with COPD are described in addition to new tools for assessing individual patient abilities and appropriate device selection for maintenance treatment...
June 1, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28547923/pediatric-heart-disease-simulation-curriculum-educating-the-pediatrician
#5
Tyler H Harris, Mark Adler, Sharon M Unti, Mary E McBride
BACKGROUND: Training guidelines state that pediatricians should be able to diagnose, manage, and triage patients with heart disease. Acutely ill cardiac patients present infrequently and with high acuity, yet residents receive less exposure to acute cardiac conditions than previous generations. Trainees must learn to manage these situations despite this gap. Simulation has been used successfully to train learners to provide acute care. We hypothesized that a simulation-based cardiac curriculum would improve residents' ability to manage cardiac patients...
May 26, 2017: Congenital Heart Disease
https://www.readbyqxmd.com/read/28546375/extracorporeal-membrane-oxygenation-for-severe-pediatric-respiratory-failure
#6
John C Lin
Extracorporeal membrane oxygenation (ECMO) was developed initially in the 1960s to support refractory respiratory failure in addition to the cardiac support inherent in a venoarterial bypass circuit. Early successes occurred predominantly in the neonatal population with subsequent randomized controlled trials and comprehensive reviews concluding therapeutic efficacy for ECMO in neonatal respiratory failure. In contrast, the evidence supporting ECMO for respiratory failure in children is less definitive. However, although pediatric randomized controlled trials have not been completed, sufficient evidence in support of ECMO as a beneficial therapy for pediatric respiratory failure exists...
June 2017: Respiratory Care
https://www.readbyqxmd.com/read/28544174/a-qualitative-study-of-younger-men-s-experience-of-heart-attack-myocardial-infarction
#7
Christopher J Merritt, Nicole de Zoysa, Jane M Hutton
OBJECTIVES: The effects of heart attack, or myocardial infarction (MI), across psychosocial domains may be particularly acute in younger adults, for whom serious health events are non-normative. MI morbidity is declining in Western countries, but in England MI numbers have plateaued for the under-45 cohort, where approximately 90% of patients are male. Qualitative research on younger adults' experience of MI is limited, and no study has sampled exclusively under-45s. This study aimed to understand how a sample of men under 45 adjusted to and made sense of MI...
May 24, 2017: British Journal of Health Psychology
https://www.readbyqxmd.com/read/28541443/the-impact-of-multidisciplinary-care-on-early-morbidity-and-mortality-after-heart-transplantation
#8
Marie Schmidhauser, Julien Regamey, Nathalie Pilon, Manuel Pascual, Sam Rotman, Carlo Banfi, René Prêtre, Philippe Meyer, Jean-Philippe Antonietti, Roger Hullin
OBJECTIVES: The impact of multidisciplinary care on outcome after heart transplantation (HTx) remains unclear. METHODS: This retrospective study investigates the impact of multidisciplinary care on the primary end point 1-year all-cause mortality (ACM) and the secondary end point mean acute cellular rejection (ACR) grade within the first postoperative year. RESULTS: This study includes a total 140 HTx recipients (median age: 53.5 years; males: 80%; donor/recipient gender mismatch: 38...
May 24, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28537509/maugeri-centre-for-telehealth-and-telecare-a-real-life-integrated-experience-in-chronic-patients
#9
Simonetta Scalvini, Palmira Bernocchi, Emanuela Zanelli, Laura Comini, Michele Vitacca
Management of chronic diseases in a progressively aging population is a major issue in western industrialized countries and telehealth is one way to ensure the continuity of care in chronic illness. We describe here our personal experience in a telehealth and telecare centre in Italy. Between January 2000 and December 2015, 1635 elderly patients (71% male) with one or more comorbidities have undergone a telehealth program tailored to their specific disease: chronic obstructive pulmonary disease (COPD)/chronic respiratory insufficiency; amyotrophic lateral sclerosis/neuromuscular diseases; chronic heart failure (CHF); post-stroke; and post-cardiac surgery patients discharged from hospital after an acute event...
January 1, 2017: Journal of Telemedicine and Telecare
https://www.readbyqxmd.com/read/28536210/systemic-inflammatory-response-syndrome-sirs-and-a-left-bundle-branch-block-lbbb-due-to-nitrofurantoin
#10
Susheer Dilbagh Gandotra, Mariola A Smotrys, Darshan B Patel, Akash Chadha
We present a case of a 74-year-old woman, who was on nitrofurantoin treatment for urinary tract infection (UTI), with fever and chills 7 hours after taking nitrofurantoin. She was hospitalised and evaluated for worsening UTI and sepsis. Initially, it appeared to be secondary to post-UTI sepsis because of possible resistant infection or conditions like pulmonary embolism or acute hepatitis. The patient also developed systemic inflammatory response syndrome, left bundle branch block (LBBB), thrombocytopaenia and transaminitis...
May 22, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28535099/do-sideline-concussion-assessments-predict-subsequent-neurocognitive-impairment-after-sport-related-concussion
#11
Alicia Sufrinko, Jamie McAllister-Deitrick, Melissa Womble, Anthony Kontos
CONTEXT:   Comprehensive, multi-domain assessment is the standard of care after sport-related concussion. However, the relationship between performance on sideline concussion-assessment tools and in-office computerized neurocognitive testing has received little attention, and the prognostic utility of sideline measures is unknown. OBJECTIVE:   To evaluate concurrent impairment on commonly used concussion measures 24 to 48 hours postinjury while also determining the predictive utility of sideline measures on computerized neurocognitive testing in the acute to subacute recovery periods postinjury...
May 23, 2017: Journal of Athletic Training
https://www.readbyqxmd.com/read/28530334/-from-theory-to-practice-implementing-the-bio-psycho-social-model-in-clinical-and-research-activities-in-the-beer-sheva-mental-health-center
#12
Hagit Cohen, Doron Todder
The Beer Sheva Mental Health Center is the second largest mental health hospital in Israel and provides acute and chronic in-patient services for the entire population of the Southern District of Israel, from Ashdod to Eilat (about 1.2 million people) from adolescence to the elderly. The outpatient services include a variety of regional specialty services such as bipolar, eating disorders, anxiety, neuromodulation, gender-oriented, attention deficit hyperactivity disorder, sleep, dual diagnosis, geronto-psychiatry and post-traumatic stress disorder clinics and various rehabilitation day-care services...
December 2016: Harefuah
https://www.readbyqxmd.com/read/28529098/differences-in-the-economic-valuation-and-determining-factors-of-informal-care-over-time-the-case-of-blood-cancer
#13
Marta Ortega-Ortega, Roberto Montero-Granados, Juan de Dios Jiménez-Aguilera
OBJECTIVE: To estimate differences in the economic valuation and sociodemographic and clinical factors associated with informal care between phases of the treatment in the case of blood cancer patients. METHODS: 139 haematological cancer patients who underwent a stem cell transplantation completed a longitudinal questionnaire according to 3 phases of the treatment: short-term (pre-transplant), medium-term (1st year post-transplant) and long-term (2nd-6th year post-transplant)...
May 19, 2017: Gaceta Sanitaria
https://www.readbyqxmd.com/read/28528711/clinical-impact-of-colonization-with-multidrug-resistant-organisms-on-outcome-after-autologous-stem-cell-transplantation-a-retrospective-single-center-study
#14
Sebastian Scheich, Claudia Reinheimer, Christian Brandt, Thomas A Wichelhaus, Michael Hogardt, Volkhard A J Kempf, Uta Brunnberg, Christian Brandts, Olivier Ballo, Ivana von Metzler, Johanna Kessel, Hubert Serve, Björn Steffen
During the last years, a significant increase in infections caused by multidrug-resistant organisms (MDRO) has been noticed, resulting in an increase of mortality in all fields of healthcare. Hematological patients are particularly affected by MDRO infections due to disease- and therapy-related immunosuppression. To determine the impact of colonization with MDRO on overall survival, we retrospectively analyzed data from patients undergoing autologous hematopoietic stem cell transplantation at our institution...
May 18, 2017: Biology of Blood and Marrow Transplantation
https://www.readbyqxmd.com/read/28528465/contrast-induced-nephropathy-cin-of-patients-with-renal-dysfunction-in-ct-examination
#15
Yasuhiro Fukushima, Hitomi Miyazawa, Junpei Nakamura, Ayako Taketomi-Takahashi, Takayuki Suto, Yoshito Tsushima
PURPOSE: To investigate the incidence and risk factors of contrast induced nephropathy (CIN) after contrast enhanced (CE) computed tomography (CT) in patients with renal dysfunction. MATERIALS AND METHODS: Two hundred sixteen inpatients with estimated glomerular filtration rates (eGFR) <60 ml/min/1.73 m(2) underwent CE CT using iodine doses of 420 or 480 mg I/kg. Data of all enrolled patients was collected for baseline serum creatinine level (SCr), post-CE CT SCr within 3 days after CE CT, and conditions considered risk factors for CIN [renal dysfunction, contrast media dose, advanced age, diabetes mellitus, no intravenous hydration, cardiac dysfunction (left ventricular ejection fraction <60%) and intensive-care unit (ICU) admission]...
May 20, 2017: Japanese Journal of Radiology
https://www.readbyqxmd.com/read/28527224/does-assist-as-needed-upper-limb-robotic-therapy-promote-participation-in-repetitive-activity-based-motor-training-in-sub-acute-stroke-patients-with-severe-paresis
#16
Anne-Gaëlle Grosmaire, Christophe Duret
BACKGROUND: Repetitive, active movement-based training promotes brain plasticity and motor recovery after stroke. Robotic therapy provides highly repetitive therapy that reduces motor impairment. However, the effect of assist-as-needed algorithms on patient participation and movement quality is not known. OBJECTIVE: To analyze patient participation and motor performance during highly repetitive assist-as-needed upper limb robotic therapy in a retrospective study...
May 19, 2017: NeuroRehabilitation
https://www.readbyqxmd.com/read/28526270/risk-factors-for-urinary-tract-infections-in-geriatric-hospitals
#17
Raphaële Girard, Sylvain Gaujard, Véronique Pergay, Pascal Pornon, Géraldine Martin Gaujard, Laurent Bourguignon
BACKGROUND: Urinary tract infection (UTI) is the most frequent nosocomial infection in geriatric units. An understanding of risk factors for infection may help identify prevention strategies. AIM: Identification of the risk factors for UTI in elderly patients. METHOD: Retrospective analysis of 3 prospective cohorts. All hospitalized patients present in, or admitted to, a geriatric unit from June 1 to June 28, for the years 2009, 2012, and 2015 were included and followed until discharge or until June 30 of the year concerned...
May 16, 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28524384/patient-reported-dietetic-care-post-hospital-for-free-living-patients-a-canadian-malnutrition-task-force-study
#18
H Keller, H Payette, M Laporte, P Bernier, J Allard, D Duerksen, L Gramlich, K Jeejeebhoy
BACKGROUND: Transitions out of hospital can influence recovery. Ideally, malnourished patients should be followed by someone with nutrition expertise, specifically a dietitian, post discharge from hospital. Predictors of dietetic care post discharge are currently unknown. The present study aimed to determine the patient factors independently associated with 30-days post hospital discharge dietetic care for free-living patients who transitioned to the community. METHODOLOGY: Nine hundred and twenty-two medical or surgical adult patients were recruited in 16 acute care hospitals in eight Canadian provinces on admission...
May 19, 2017: Journal of Human Nutrition and Dietetics: the Official Journal of the British Dietetic Association
https://www.readbyqxmd.com/read/28514361/-the-complications-of-transethmoidal-decompressive-orbitotomy-associated-with-endocrine-ophthalmopathy
#19
P A Kochetkov, Ya O Grusha, V M Svistushkin, S S Danilov
The objective of the present study was the analysis of the results of transethmoidal decompressive orbitotomy (TEDO) with the resection of the bone matrix of the medial and inferior orbital walls in the patients presenting with endocrine ophthalmopathy (EOP) with the purpose of reduction of the risk of development of this pathological conditions. A total of 51 patient with EOP at the stage of complete remission or pharmacotherapeutic compensation underwent transethmoidal decompressive medial orbitotomy in the ENT Clinic of 1 I...
2017: Vestnik Otorinolaringologii
https://www.readbyqxmd.com/read/28512772/subspecialty-approach-for-the-management-of-acute-cholecystitis-an-alternative-to-acute-surgical-unit-model-of-care
#20
Sonia Tran, Vincent Choi, Kirsten Hepburn, Nathan Hewitt, Joel Zhou, Daniel L Chan, Michael L Talbot
BACKGROUND: Acute cholecystitis is a common condition. Recent studies have shown an association between creation of an acute surgical unit (ASU) and improved outcomes. This study aimed to evaluate the outcomes of a subspecialty based approach to the management of acute cholecystitis as an alternative to the traditional 'generalist' general surgery approach or the ASU model. METHOD: A 6-year retrospective analysis of outcomes in patients admitted under a dedicated upper gastrointestinal service for acute cholecystitis undergoing emergency laparoscopic cholecystectomy...
May 16, 2017: ANZ Journal of Surgery
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