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Xin Yuan, Bin Li, Hansong Sun, Yan Yang, Hong Meng, Liang Xu, Yunhu Song, Jianping Xu
BACKGROUND: It is uncertain with the outcomes of different repair strategies of anomalous left coronary artery from pulmonary artery (ALCAPA) in adolescent and adult patients. The long-term outcomes of reimplantation and Takeuchi repair were compared in this study. METHODS: We conducted a retrospective review of data collected from patients receiving ALCAPA repair at our institute from January 2005 to December 2016. Short- and long-term outcomes of re-implantation and Takeuchi repair were compared...
June 18, 2018: Annals of Thoracic Surgery
Salah S Al-Zaiti, Ziad Faramand, Mohammad O Alrawashdeh, Susan M Sereika, Christian Martin-Gill, Clifton Callaway
BACKGROUND: Many of the clinical risk scores routinely used for chest pain assessment have not been validated in patients at high risk for acute coronary syndrome (ACS). We performed an independent comparison of HEART, TIMI, GRACE, FRISC, and PURSUIT scores for identifying chest pain due to ACS and for predicting 30-day death or re-infarction in patients arriving through Emergency Medical Services (EMS). METHODS AND RESULTS: We enrolled consecutive EMS patients evaluated for chest pain at three emergency departments...
June 8, 2018: American Journal of Emergency Medicine
Thomas S Metkus, Alejandro Suarez-Pierre, Todd C Crawford, Jennifer S Lawton, Lee Goeddel, Jeffrey Dodd-O, Monica Mukherjee, Theodore P Abraham, Glenn J Whitman
BACKGROUND: Diastolic dysfunction (DD) identified on echocardiography predicts mortality after cardiac surgery, however the most useful diastolic parameters for assessment and the association of DD with prolonged mechanical ventilation, ICU re-admission, and hospital length of stay are not established. METHODS: We included patients that underwent coronary artery bypass grafting (CABG), aortic valve replacement (AVR) or a combined procedure (CAB-AVR) from 2010 to 2016, and who had preoperative transthoracic echocardiography (TTE) at our institution within 6 months of the operation...
June 15, 2018: Journal of Cardiothoracic Surgery
Yuichi Nakaseko, Hironori Ohdaira, Masashi Yoshida, Masaki Kitajima, Yutaka Suzuki
Introduction: We investigated the validity of the clinical pathway of early oral intake using a special type of food "iEat™" for patients after laparoscopic gastric cancer surgery. Methods: Fifty-two patients who underwent laparoscopic surgery for gastric cancer between April 2012 and October 2013 were the participants. We provided postoperative care in accordance with a clinical pathway for laparoscopic gastrectomy that begins oral intake with "iEat™ the day after surgery...
July 2018: Annals of Medicine and Surgery
R S Nannan Panday, C P Subbe, L S van Galen, J Kellett, M Brabrand, C H Nickel, P W B Nanayakkara
Readmissions are treated as adverse events in many healthcare systems. Causes can be physiological deterioration or breakdown of social support systems. We investigated data from a European multi-centre study of readmissions for changes in vital signs between index admission and readmission. Data sets were graded according to the National Early Warning Score (NEWS). Of 487 patients in whom NEWS could be calculated on discharge and again on re-admission, 39.6% had worse vital signs with a NEWS score difference ≥ 2 points while only 7...
2018: Acute Medicine
M Williams, M Ng, M Ashworth
Background: Globally the incidence of fragility hip fractures is rising with increasingly elderly and co-morbid patients. These injuries are associated with a high morbidity and mortality. Aims: This clinical study's primary outcome is to establish the rate of operative inadvertent hypothermia (<36 °C) in elderly hip fracture patients (>65 years old). We also aimed to identify risk factors and outcomes in patients with inadvertent hypothermia. Patients and Methods: A single centre, retrospective study of 929 hip fracture patients managed operatively between June 2015 and July 2017 was conducted...
June 2018: Journal of Orthopaedics
Ehete Bahiru, Tecla Temu, Bernard Gitura, Carey Farquhar, Mark D Huffman, Frederick Bukachi
BACKGROUND: Acute coronary syndrome (ACS) is understudied in sub-Saharan Africa despite its increasing disease burden. We sought to create an ACS registry at Kenyatta National Hospital to evaluate the presentation, management and outcomes of ACS patients. METHODS: From November 2016 to April 2017, we conducted a retrospective review of ACS cases managed at Kenyatta National Hospital between 2013 and 2016, with a primary discharge diagnosis of ACS, based on International Classification of Diseases (ICD) 10 coding (I20-I24)...
May 24, 2018: Cardiovascular Journal of Africa
Chih-Hsien Liao, Ning Lu, Chao-Hsiun Tang, Hui-Chih Chang, Kuo-Cherh Huang
Background: There is still significant uncertainty as to whether market competition raises or lowers clinical quality in publicly funded healthcare systems. We attempted to assess the effects of market competition on inpatient care quality of stroke patients in a retrospective study of the universal single-payer health insurance system in Taiwan. Methods: In this 11-year population-based study, we conducted a pooled time-series cross-sectional analysis with a fixed-effects model and the Hausman test approach by utilizing two nationwide datasets: the National Health Insurance Research Database and the National Hospital and Services Survey in Taiwan...
June 4, 2018: European Journal of Public Health
Marita Macken, James Chan, Bernadette O'Hare, Hannah V Thornton, Queen Dube, Neil Kennedy
Background: Provider initiated testing and counselling (PITC) is recommended for all inpatients in Malawi if they have not been tested in the previous 3 months. However testing rates remain low among children. We audited the effect of implementing a bedside diagnostic HIV testing service to determine if it would improve testing rates amongst paediatric inpatients. Methods: We audited the existing HIV testing service to determine the numbers of children being tested for HIV...
September 2017: Malawi Medical Journal: the Journal of Medical Association of Malawi
Michael Kosasih, Aubrey A Almeida, Julian A Smith
BACKGROUND: Sutureless aortic valve replacement (SU-AVR) offers an alternative to traditional aortic valve replacement (AVR) and is becoming widely performed in many hospitals. The aim of the current study was to evaluate the early experience in SU-AVR with the Perceval S bioprosthesis at Monash Medical Centre. METHODS: Fifty-two patients who underwent SU-AVR were retrospectively analysed (mean age: 74.8±6.5years). Data regarding preoperative and operative details, hospital stay, postoperative outcomes within 30days after surgery, re-admissions and longer term echocardiographic data were collected from the relevant hospital databases...
May 18, 2018: Heart, Lung & Circulation
Nayani Prasangika Weerasinghe, Dhammika Vidanagama, Bilesha Perera, Herath Mudiyanselage Meththananda Herath, Ajith De Silva Nagahawatte
OBJECTIVE: To identify the validity of surveillance cultures in predicting causative organism(s) of late onset neonatal sepsis. RESULTS: Prospective analytical study was conducted from January to April 2011 at the Neonatal Intensive Care Unit, Teaching Hospital, Karapitiya, Galle, Sri Lanka. Fifty neonates were screened on admission and weekly thereafter for colonization with potential pathogens. On suspicion of infection, relevant samples were cultured and tested for antibiotic sensitivity...
May 29, 2018: BMC Research Notes
Angel E Alsina, Alexia Athienitis, Ahmad Nakshabandi, Reinaldo E Claudio, Sadaf Aslam, Jorge Arroyo, Iain Hillenberg, Alejandra Mallorga, Manohar Lahoti, Nyingi Kemmer
BACKGROUND: Elective abdominal surgeries in patients with cirrhosis have been discouraged due to the high risk of complications. This study investigates the outcomes and safety of surgeries for hernias, and laparoscopic cholecystectomies in cirrhotic patients. METHODS: A retrospective cohort study that compared 91 cirrhotic patients to a control group of non-cirrhotic patients operated by liver transplant surgeons was conducted between 2009 and 2015. RESULTS: No statistical significance found in re-admission rates or complication rates (p = 0...
May 12, 2018: American Journal of Surgery
Sumeet K Asrani, Maria Kouznetsova, Gerald Ogola, Thomas Taylor, Andrew Masica, Brandon Pope, James Trotter, Patrick Kamath, Fasiha Kanwal
BACKGROUND & AIMS: Chronic liver disease (CLD) is a common and expensive condition, and studies of CLD-related hospitalizations have underestimated the true burden of disease. We analyzed data from a large diverse healthcare system to compare time trends in CLD-related hospitalizations with those of congestive heart failure (CHF) or chronic obstructive pulmonary disease (COPD). METHODS: We collected data from a large healthcare system in Texas on hospitalizations related to CLD (n=27,783), CHF (n=60,415), and COPD (n=34,199) from January 1, 2004 through December 31, 2013...
May 23, 2018: Gastroenterology
Sabrina Gmuca, Rui Xiao, Pamela F Weiss, Amy T Waldman, Jeffrey S Gerber
Background: Treatment algorithms for neuromyelitis optica spectrum disorder (NMOSD) vary, and sparse data exist regarding the impact of initial treatments on disease course. We aimed to determine whether administration of rituximab during first hospitalization reduces 1-year readmission rates. Methods: We conducted a retrospective cohort study of subjects with NMOSD using the Pediatric Health Information System database from 2005-2015. Subjects were ages 1 to 21 years who received glucocorticoids and an ICD-9-CM code indicating neuromyelitis optica (NMO) during first hospitalization...
April 2018: Multiple Sclerosis and Demyelinating Disorders
Shinya Yamada, Akiomi Yoshihisa, Yu Sato, Takamasa Sato, Masashi Kamioka, Takashi Kaneshiro, Masayoshi Oikawa, Atsushi Kobayashi, Hitoshi Suzuki, Takafumi Ishida, Yasuchika Takeishi
BACKGROUND: Heart failure (HF) patients have a higher risk of recurrent HF and cardiac death, and electrical remodeling is considered to be an important factor for HF progression. The present study aimed to validate the utility of electrocardiogram and Holter monitoring for the risk stratification of HF patients. METHODS: Our study comprised 215 patients (144 males, mean age 62 years) who had been hospitalized due to acute decompensated HF. Electrocardiogram (QRS duration and QTc interval) and 24-hour Holter monitoring (heart rate variability, heart rate turbulence and T-wave alternans [TWA]) were performed in stable condition before discharge...
May 18, 2018: Journal of Cardiovascular Electrophysiology
Anne Neumann, Enno Swart, Dennis Häckl, Roman Kliemt, Stefanie March, Denise Küster, Katrin Arnold, Thomas Petzold, Fabian Baum, Martin Seifert, Jessika Weiß, Andrea Pfennig, Jochen Schmitt
BACKGROUND: Close, continuous and efficient collaboration between different professions and sectors of care is necessary to provide patient-centered care for individuals with mental disorders. The lack of structured collaboration between in- and outpatient care constitutes a limitation of the German health care system. Since 2012, a new law in Germany (§64b Social code book (SGB) V) has enabled the establishment of cross-sectoral and patient-centered treatment models in psychiatry. Such model projects follow a capitation budget, i...
May 18, 2018: BMC Psychiatry
Kendall C Shultes, Jerrica E Shuster, Scott Micek, Justin M Vader, Keki Balsara, Akinobu Itoh, Bethany R Tellor
BACKGROUND: Limited data exist on the incidence and outcome of early infection after orthotopic heart transplantation (OHT). The purpose of this study was to describe characteristics and outcomes of OHT recipients with an early infection and to identify predictors of such infections. METHODS: This retrospective, single-center study included patients greater than 18 years of age who underwent OHT from February 2009 to May 2014 and had an infection within 30 days of transplantation...
May 18, 2018: Surgical Infections
M Buttard, A Putot, P d'Athis, L Pioro, S Asgassou, S Putot, M Deïdda, C Laborde, M Dipanda, R Mahmoudi, P Manckoundia
INTRODUCTION: Furosemide is very often prescribed in France. It may cause important adverse effects especially in elderly persons. In order to limit its misuse and excessive expenditure for health insurance organizations, the European Society of Cardiology drafted strict guidelines for its prescription. We conducted a study in this population to determine the rate of prescription of furosemide in elderly persons outside the guidelines. METHOD: This was a prospective, single-centre, observational study bearing on elderly persons aged 75years and more admitted to a geriatric acute-care unit over a period of 6months...
May 11, 2018: Annales de Cardiologie et D'angéiologie
Kate E McBride, Michael J Solomon, Jane M Young, Daniel Steffens, Tim J Lambert, Nick Glozier, Paul G Bannon
BACKGROUND: People with comorbid mental illness have poorer health status and disparate access to healthcare. Several studies internationally have reported mixed findings regarding the association between mental illness and surgical patient outcomes. This study examines the surgical outcomes in people with decompensated serious mental illness (SMI) within the setting of the Australian universal healthcare system. METHODS: Retrospective cohort study involving elective overnight surgical patients aged 18 years and above who attended a large public tertiary referral hospital in Sydney, Australia, between 2010 and 2014...
May 14, 2018: ANZ Journal of Surgery
Quan Huynh, Kazuaki Negishi, Carmine De Pasquale, James Hare, Dominic Leung, Tony Stanton, Thomas H Marwick
OBJECTIVES: To investigate whether enrolment of patients in management programs after hospitalisation for heart failure (HF) reduces the likelihood of post-hospital adverse outcomes. DESIGN: Cohort study in which associations between adverse outcomes at 30 and 90 days for people hospitalised for HF and baseline clinical, socio-demographic and blood pathology factors, and with post-discharge management strategies, were assessed. Setting, participants: 906 patients with HF were prospectively enrolled in five Australian states at cardiology departments with expertise in treating people with HF...
May 14, 2018: Medical Journal of Australia
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