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https://www.readbyqxmd.com/read/28320158/addressing-post-stroke-care-in-rural-areas-with-peru-as-a-case-study-placing-emphasis-on-evidence-based-pragmatism
#1
REVIEW
J Jaime Miranda, Miguel G Moscoso, Lijing L Yan, Francisco Diez-Canseco, Germán Málaga, Hector H Garcia, Bruce Ovbiagele
Stroke is a major cause of death and disability, with most of its burden now affecting low- and middle-income countries (LMIC). People in rural areas of LMIC who have a stroke receive very little acute stroke care and local healthcare workers and family caregivers in these regions lack the necessary knowledge to assist them. Intriguingly, a recent rapid growth in cell-phone use and digital technology in rural areas has not yet been appropriately exploited for health care training and delivery purposes. What should be done in rural areas, at the community setting-level, where access to healthcare is limited remains a challenge...
April 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28319564/improvement-in-the-outcomes-of-meld-%C3%A2-40-liver-transplantation-an-analysis-of-207-consecutive-transplants-in-a-highly-competitive-dsa
#2
Victor Nekrasov, Lea Matsuoka, Navpreet Kaur, Alejandro Pita, Gilbert Whang, Shu Cao, Susan Groshen, Sophoclis Alexopoulos
BACKGROUND: Organ donor shortages continue to persist, especially in regions of the United States where competition is highest and recipients frequently attain a MELD score ≥ 40 prior to transplantation. The benefits of Share 35 in highly competitive regions may be underestimated when examining the collective national experience. The purpose of this study is to examine the outcomes of liver transplantation in recipients with a MELD ≥ 40 after implementation of Share 35 in a single center located in region 5...
March 18, 2017: Transplantation
https://www.readbyqxmd.com/read/28318768/clinical-development-strategy-for-a-candidate-group-a-streptococcal-vaccine
#3
REVIEW
Florian Schödel, Nicole J Moreland, Janet T Wittes, Kim Mulholland, Ian Frazer, Andrew C Steer, John D Fraser, Jonathan Carapetis
GroupA streptococci (GAS) cause a wide spectrum of diseases ranging from benign pharyngitis and skin infections to severe invasive disease and the immune sequelae rheumatic fever and rheumatic heart disease. Pharyngitis, one of the most frequent diseases caused by GAS, is highly prevalent in school-age children in temperate climates and a major cause of antibiotic use. An efficacious vaccine would reduce disease burden associated with pharyngitis and the need of care for sick children. Importantly, GAS pharyngitis is recognised as the main precursor for acute rheumatic fever so a vaccine that is efficacious against GAS pharyngitis should also prevent acute rheumatic fever and rheumatic heart disease...
March 16, 2017: Vaccine
https://www.readbyqxmd.com/read/28315553/car-t-cell-therapy-pediatric-patients-with-relapsed-and-refractory-acute-lymphoblastic-leukemia%C3%A2
#4
Colleen Callahan, Diane Baniewicz, Beth Ely
BACKGROUND: Immunotherapy provides a promising treatment option for children and adolescents with refractory or relapsed acute lymphoblastic leukemia (ALL). 
. OBJECTIVES: This article presents a hospital's experience with providing chimeric antigen receptor (CAR) T-cell therapy, followed by a detailed discussion of the trajectory of treatment provided for pediatric patients and their families.
. METHODS: Clinical experience in delivering care to pediatric patients undergoing CAR T-cell therapy is described...
April 1, 2017: Clinical Journal of Oncology Nursing
https://www.readbyqxmd.com/read/28314646/daily-feedback-from-accelerometers-increases-time-spent-walking-outside-of-therapy-for-patients-in-post-acute-care-rehabilitation-synopsis
#5
Nora Shields
No abstract text is available yet for this article.
February 27, 2017: Journal of Physiotherapy
https://www.readbyqxmd.com/read/28314645/daily-feedback-from-accelerometers-increases-time-spent-walking-outside-of-therapy-for-patients-in-post-acute-care-rehabilitation-commentary
#6
Coralie English
No abstract text is available yet for this article.
February 27, 2017: Journal of Physiotherapy
https://www.readbyqxmd.com/read/28306694/real-world-use-of-ticagrelor-and-prasugrel-in-patients-with-nstemi-undergoing-percutaneous-coronary-intervention
#7
Vincenzo Sucato, Egle Corrado, Carmelo Castellana, Michele Carella, Simona Raso, Giuseppe Coppola, Giuseppe Andolina, Giuseppina Novo, Salvatore Evola, Salvatore Novo
OBJECTIVE: This retrospective observational study sought to describe the safety and efficacy profile of prasugrel and ticagrelor in patients with non-ST-segment elevation myocardial infarction (NSTEMI), who were admitted to the coronary intensive care unit (CICU) and underwent primary percutaneous coronary intervention (PCI). BACKGROUND AND METHODS: Dual antiplatelet therapy is mandatory for all the patients with acute coronary syndrome, who underwent PCI. Our study includes 111 patients with NSTEMI, who underwent PCI, in a maximum time of 72 h after their ischemic event...
March 16, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28306590/the-use-of-dipyrone-in-the-icu-is-associated-with-acute-kidney-injury-a-retrospective-cohort-analysis
#8
Thomas Stueber, Laura Buessecker, Andreas Leffler, Hans-Jörg Gillmann
BACKGROUND: Use of dipyrone (metamizole) in perioperative and ICU pain therapy remains controversial due to a lack of solid evidence weighing dipyrone benefit against its potential life-threatening complications. Although dipyrone has known analgesic and antipyretic properties, its mechanisms of actions are incompletely understood. Although dipyrone effects on renal vasodilator prostaglandin synthesis are documented, little is known about its potential renal side effects, especially in the critical care environment...
March 16, 2017: European Journal of Anaesthesiology
https://www.readbyqxmd.com/read/28304205/stenting-of-the-cervical-internal-carotid-artery-in-acute-stroke-management-the-karolinska-experience
#9
Anastasios Mpotsaris, Christoph Kabbasch, Jan Borggrefe, Vamsi Gontu, Michael Soderman
Background Emergency stent placement in the extracranial internal carotid artery in combination with anterior circulation thrombectomy is a routine procedure. Yet, precise indications and clinical safety in this setting remains controversial. Present data for mechanical thrombectomy include few studies with acute stenting of tandem occlusions. We evaluated the feasibility, safety and clinical outcome of this endovascular treatment in a retrospective analysis of all consecutive cases at a comprehensive stroke centre...
April 2017: Interventional Neuroradiology
https://www.readbyqxmd.com/read/28302593/outcomes-in-child-health-exploring-the-use-of-social-media-to-engage-parents-in-patient-centered-outcomes-research
#10
Michele P Dyson, Kassi Shave, Ricardo M Fernandes, Shannon D Scott, Lisa Hartling
BACKGROUND: With the rapid growth of technology and its improved accessibility globally, social media is gaining an increasingly important role in health care. Patients are frequently engaging with social media to access information, share content, and interact with others in online health communities. However, the use of social media as a stakeholder engagement strategy has been minimally explored, and effective methods for involving participants in research on the identification of patient-centered outcomes remain unknown...
March 16, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28299795/interruption-to-antiplatelet-therapy-early-after-acute-ischaemic-stroke-a-nested-case-control-study
#11
Wardati Mazlan-Kepli, Rachael L MacIsaac, Matthew Walters, Philip Michael William Bath, Jesse Dawson
AIMS: Antiplatelet drugs are often discontinued early after ischaemic stroke, either because of poor compliance, complications or withdrawal of care. It is unclear whether this places patients at increased risk of recurrence. We explored the association between cardiovascular event rate and persistence with prescribed antiplatelet drugs. METHODS: We used a matched case-control design using the Virtual International Stroke Trials Archive (VISTA). Cases were patients who had an acute coronary syndrome, recurrent stroke or transient ischaemic attack within 90 days post-stroke and were matched for age ±10 years and sex with up to four controls...
March 16, 2017: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28296663/acute-decompensation-in-pediatric-cardiac-patients-outcomes-after-rapid-response-events
#12
Aarti C Bavare, Kimia S Rafie, Patricia X Bastero, Joseph L Hagan, Paul A Checchia
OBJECTIVE: We studied rapid response events after acute clinical instability outside ICU settings in pediatric cardiac patients. Our objective was to describe the characteristics and outcomes after rapid response events in this high-risk cohort and elucidate the cardiac conditions and risk factors associated with worse outcomes. DESIGN: A retrospective single-center study was carried out over a 3-year period from July 2011 to June 2014. SETTING: Referral high-volume pediatric cardiac center located within a tertiary academic pediatric hospital...
March 14, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28296181/-white-out-after-lung-transplantation-a-multicentre-cohort-description-of-late-acute-graft-failure
#13
Stijn E Verleden, Jens Gottlieb, Adriana Dubbeldam, Geert M Verleden, Hendrik Suhling, Tobias Welte, Robin Vos, Mark Greer
Graft failure represents a leading cause of mortality following organ transplantation. Acute late-onset graft failure has not been widely reported. This paper describes the demographics, CT imaging pathology findings and treatment of patients presenting with the latter. A retrospective review of lung transplant recipients at 2 large-volume centres was performed. Acute late-onset graft failure was defined as sudden onset of bilateral infiltrates with an oxygenation index <200 without identifiable cause or concurrent extra-pulmonary organ failure...
March 12, 2017: American Journal of Transplantation
https://www.readbyqxmd.com/read/28295151/use-of-life-support-in-acutely-admitted-icu-patients-an-international-cohort-study
#14
T S Meyhoff, M Krag, P B Hjortrup, A Perner, M H Møller
BACKGROUND: Use of life support in intensive care unit (ICU) patients has been associated with increased risk of poor outcome. The prognostic importance of the duration of support is less studied. We assessed the use of life support and the association between its duration and 90-day mortality in a contemporary cohort of acutely admitted adult ICU patients. METHODS: We performed a post-hoc analysis of the SUP-ICU 7-day inception cohort study (n = 1034), which was conducted in 97 ICUs in 11 countries...
March 10, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/28293378/hepatorenal-syndrome-update-on-diagnosis-and-therapy
#15
EDITORIAL
Juan G Acevedo, Matthew E Cramp
Hepatorenal syndrome (HRS) is a manifestation of extreme circulatory dysfunction and entails high morbidity and mortality. A new definition has been recently recommended by the International Club of Ascites, according to which HRS diagnosis relies in serum creatinine changes instead that on a fixed high value. Moreover, new data on urinary biomarkers has been recently published. In this sense, the use of urinary neutrophil gelatinase-associated lipocalin seems useful to identify patients with acute tubular necrosis and should be employed in the diagnostic algorithm...
February 28, 2017: World Journal of Hepatology
https://www.readbyqxmd.com/read/28292629/the-5-clinical-pillars-of-value-for-total-joint-arthroplasty-in-a-bundled-payment-paradigm
#16
Kelvin Kim, Richard Iorio
BACKGROUND: Our large, urban, tertiary, university-based institution reflects on its 4-year experience with Bundled Payments for Care Improvement. We will describe the importance of 5 clinical pillars that have contributed to the early success of our bundled payment initiative. We are convinced that value-based care delivered through bundled payment initiatives is the best method to optimize patient outcomes while rewarding surgeons and hospitals for adapting to the evolving healthcare reforms...
February 14, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/28292582/-profile-and-evolution-of-chronic-complex-patients-in-a-subacute-unit
#17
Neus Gual, Anna Yuste Font, Belen Enfedaque Montes, Carles Blay Pueyo, Remedios Martín Álvarez, Marco Inzitari
OBJECTIVE: To improve the management of geriatric pluripathologic patients in Catalonia, the identification of chronic complex patient (PCC) or patients with advanced chronic disease (MACA) has been promoted. Patients with exacerbated chronic diseases are promoted to be admitted in subacute units (SG) located in intermediate hospitals and specialized in geriatric care, as an alternative to acute hospital. The results of the care process in patients identified as PCC/MACA in SG have not been evaluated...
March 11, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28292507/opioid-exit-plan-a-pharmacist-s-role-in-managing-acute-postoperative-pain
#18
Cheryl Genord, Timothy Frost, Deeb Eid
OBJECTIVES: The benefits of a pharmacist's involvement in medication reconciliation and discharge counseling are well documented in the literature as improving patient outcomes. In contrast, no studies have focused on the initiation of a pharmacist-led opioid exit plan (OEP) for acute postoperative pain management. This paper summarizes a pharmacist-led OEP practice model and the potential role that pharmacists and student pharmacists can have at the point of admission, during postoperative recovery, and on discharge in acute pain management patients...
March 2017: Journal of the American Pharmacists Association: JAPhA
https://www.readbyqxmd.com/read/28290631/acute-coronary-syndrome-current-treatment
#19
Timothy L Switaj, Scott R Christensen, Dean M Brewer
Acute coronary syndrome continues to be a significant cause of morbidity and mortality in the United States. Family physicians need to identify and mitigate risk factors early, as well as recognize and respond to acute coronary syndrome events quickly in any clinical setting. Diagnosis can be made based on patient history, symptoms, electrocardiography findings, and cardiac biomarkers, which delineate between ST elevation myocardial infarction and non-ST elevation acute coronary syndrome. Rapid reperfusion with primary percutaneous coronary intervention is the goal with either clinical presentation...
February 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28284465/neurological-disorders-in-liver-transplant-candidates-pathophysiology-and-clinical-assessment
#20
REVIEW
Paolo Feltracco, Annachiara Cagnin, Cristiana Carollo, Stefania Barbieri, Carlo Ori
Compromised liver function, as a consequence of acute liver insufficiency or severe chronic liver disease may be associated with various neurological syndromes, which involve both central and peripheral nervous system. Acute and severe hyperammoniemia inducing cellular metabolic alterations, prolonged state of "neuroinflammation", activation of brain microglia, accumulation of manganese and ammonia, and systemic inflammation are the main causative factors of brain damage in liver failure. The most widely recognized neurological complications of serious hepatocellular failure include hepatic encephalopathy, diffuse cerebral edema, Wilson disease, hepatic myelopathy, acquired hepatocerebral degeneration, cirrhosis-related Parkinsonism and osmotic demyelination syndrome...
February 27, 2017: Transplantation Reviews
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