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https://www.readbyqxmd.com/read/28640730/treating-patients-with-venous-leg-ulcers-in-the-acute-setting-part-1
#1
Irene Anderson
Leg ulcers present with a variety of aetiologies, sometimes in combination. The most common aetiology is venous, with treament involving compression, elevation and exercise; the most common treatment setting is the community. However, people with leg ulcers do sometimes require admission to hospital for conditions and situations which may, or may not, be ulcer-related. There is a lack of contemporary evidence on the experience of inpatients and insufficient analysis of the impact on healing and complications to the lower limb when patients with leg ulcers and compression therapy are admitted to hospital...
June 22, 2017: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/28636200/functional-impairment-an-unmeasured-marker-of-medicare-costs-for-postacute-care-of-older-adults
#2
S Ryan Greysen, Irena Stijacic Cenzer, W John Boscardin, Kenneth E Covinsky
OBJECTIVES: To assess the effects of preadmission functional impairment on Medicare costs of postacute care up to 365 days after hospital discharge. DESIGN: Longitudinal cohort study. SETTING: Health and Retirement Study (HRS). PARTICIPANTS: Nationally representative sample of 16,673 Medicare hospitalizations of 8,559 community-dwelling older adults from 2000 to 2012. MEASUREMENTS: The main outcome was total Medicare costs in the year after hospital discharge, assessed according to Medicare claims data...
June 21, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28635539/an-old-challenge-with-new-promises-a-systematic-review-on-comprehensive-geriatric-assessment-in-long-term-care-facilities
#3
Francesco Panza, Vincenzo Solfrizzi, Madia Lozupone, Maria Rosaria Barulli, Francesca D'Urso, Roberta Stallone, Vittorio Dibello, Alessia Noia, Cristina Di Dio, Antonio Daniele, Antonello Bellomo, Davide Seripa, Antonio Greco, Giancarlo Logroscino
Comprehensive geriatric assessment (CGA) is a multidimensional and multidisciplinary diagnostic process focused on determining the clinical profile, pathological risk, residual skills, short- and long-term prognosis, and the personalized therapeutic and care plan of the functionally compromised and frail older subjects. Previous evidence suggested that the effectiveness of CGA programs may be influenced by the settings where the CGA is performed [i.e., hospital, post-hospital discharge/ long-term care facilities (LTCF), or community/home] as well as the specific clinical conditions of older frail individuals...
June 21, 2017: Rejuvenation Research
https://www.readbyqxmd.com/read/28634475/cesarean-or-vaginal-birth-does-not-impact-the-longitudinal-development-of-the-gut-microbiome-in-a-cohort-of-exclusively-preterm-infants
#4
Christopher J Stewart, Nicholas D Embleton, Elizabeth Clements, Pamela N Luna, Daniel P Smith, Tatiana Y Fofanova, Andrew Nelson, Gillian Taylor, Caroline H Orr, Joseph F Petrosino, Janet E Berrington, Stephen P Cummings
The short and long-term impact of birth mode on the developing gut microbiome in neonates has potential implications for the health of infants. In term infants, the microbiome immediately following birth across multiple body sites corresponds to birth mode, with increased Bacteroides in vaginally delivered infants. We aimed to determine the impact of birth mode of the preterm gut microbiome over the first 100 days of life and following neonatal intensive care unit (NICU) discharge. In total, 867 stool samples from 46 preterm infants (21 cesarean and 25 vaginal), median gestational age 27 weeks, were sequenced (V4 region 16S rRNA gene, Illumina MiSeq)...
2017: Frontiers in Microbiology
https://www.readbyqxmd.com/read/28627860/the-world-health-organization-disability-assessment-schedule-2-0-can-predict-the-institutionalization-of-the-patients-with-stroke
#5
Hsiang-Yueh Hu, Wen-Chou Chi, Kwang-Hwa Chang, Chia-Feng Yen, Reuben Escorpizo, Hua-Fang Liao, Shih-Wei Huang, Tsan-Hon Liou
BACKGROUND: The World Health Organization Disability Assessment Schedule 2.0 (WHODAS 2.0) is a well-known questionnaire used to evaluate disability. We can not only evaluate disability but also obtain additional information by using the standardized WHODAS 2.0 scores. AIM: To predict the institutionalization of the patients with stroke by using the standardized WHODAS 2.0 scores. DESIGN: Observational study. SETTING: The data of 10,255 patients with stroke were acquired from the Data Bank of Persons with Disabilities (TDPD) in Taiwan...
June 19, 2017: European Journal of Physical and Rehabilitation Medicine
https://www.readbyqxmd.com/read/28626848/older-adult-falls-prevention-behaviors-60-days-post-discharge-from-an-urban-emergency-department-after-treatment-for-a-fall
#6
Kalpana Narayan Shankar, Nicole J Treadway, Alyssa A Taylor, Alan H Breaud, Elizabeth W Peterson, Jonathan Howland
BACKGROUND: Falls are a common and debilitating health problem for older adults. Older adults are often treated and discharged home by emergency department (ED)-based providers with the hope they will receive falls prevention resources and referrals from their primary care provider. This descriptive study investigated falls prevention activities, including interactions with primary care providers, among community-dwelling older adults who were discharged home after presenting to an ED with a fall-related injury...
December 2017: Injury Epidemiology
https://www.readbyqxmd.com/read/28625203/understanding-temporal-relationships-between-depression-falls-and-physical-activity-in-a-cohort-of-post-hospitalized-older-adults-a-breakthrough-or-a-conundrum
#7
Den-Ching A Lee, Aislinn F Lalor, Grant Russell, Rene Stolwyk, Ted Brown, Fiona McDermott, Terry P Haines
BACKGROUND: Clinical depression affects approximately 15% of community-dwelling older adults, of which half of these cases present in later life. Falls and depressive symptoms are thought to co-exist, while physical activity may protect an older adult from developing depressive symptoms. This study investigates the temporal relationships between depressive symptoms, falls, and participation in physical activities amongst older adults recently discharged following extended hospitalization...
June 19, 2017: International Psychogeriatrics
https://www.readbyqxmd.com/read/28619405/treating-childhood-malnutrition-in-rural-haiti-program-outcomes-and-obstacles
#8
C Nicholas Cuneo, Emily Dansereau, Anand R Habib, Mary Davies, Samuel Ware, Kenneth Kornetsky
BACKGROUND: Haiti has the worst malnutrition rate in the Western hemisphere. In October 2010, a cholera epidemic erupted and spread rapidly throughout the country, straining Haiti's already fragile health infrastructure across all levels of care. This study reviews data from an outpatient therapeutic feeding program (OTP) for acute childhood malnutrition at a clinic in rural Haiti with a focus on the effect of the 2010 cholera epidemic on program operations. METHODS: A retrospective chart review was conducted for the complete set of patients who were enrolled in the OTP from its inception in March 2009 through January 2014...
March 2017: Annals of Global Health
https://www.readbyqxmd.com/read/28619124/multiplex-tests-to-identify-gastrointestinal-bacteria-viruses-and-parasites-in-people-with-suspected-infectious-gastroenteritis-a-systematic-review-and-economic-analysis
#9
Karoline Freeman, Hema Mistry, Alexander Tsertsvadze, Pam Royle, Noel McCarthy, Sian Taylor-Phillips, Rohini Manuel, James Mason
BACKGROUND: Gastroenteritis is a common, transient disorder usually caused by infection and characterised by the acute onset of diarrhoea. Multiplex gastrointestinal pathogen panel (GPP) tests simultaneously identify common bacterial, viral and parasitic pathogens using molecular testing. By providing test results more rapidly than conventional testing methods, GPP tests might positively influence the treatment and management of patients presenting in hospital or in the community. OBJECTIVE: To systematically review the evidence for GPP tests [xTAG(®) (Luminex, Toronto, ON, Canada), FilmArray (BioFire Diagnostics, Salt Lake City, UT, USA) and Faecal Pathogens B (AusDiagnostics, Beaconsfield, NSW, Australia)] and to develop a de novo economic model to compare the cost-effectiveness of GPP tests with conventional testing in England and Wales...
April 2017: Health Technology Assessment: HTA
https://www.readbyqxmd.com/read/28618896/managing-risk-during-care-transitions-when-approaching-end-of-life-a-qualitative-study-of-patients-and-health-care-professionals-decision-making
#10
Maureen A Coombs, Roses Parker, Kay de Vries
BACKGROUND: Increasing importance is being placed on the coordination of services at the end of life. AIM: To describe decision-making processes that influence transitions in care when approaching the end of life. DESIGN: Qualitative study using field observations and longitudinal semi-structured interviews. SETTING/PARTICIPANTS: Field observations were undertaken in three sites: a residential care home, a medical assessment unit and a general medical unit in New Zealand...
July 2017: Palliative Medicine
https://www.readbyqxmd.com/read/28617790/clinical-management-and-patient-persistence-with-antibiotic-course-in-suspected-group-a-streptococcal-pharyngitis-for-primary-prevention-of-rheumatic-fever-the-perspective-from-a-new-zealand-emergency-department
#11
Jeremy J Mathan, Jozsef Ekart, Anthony Houlding, Gary Payinda, Clair Mills
AIM: Rates of acute rheumatic fever in the Northland region are historically among the highest in New Zealand, impacting disproportionately on Māori children and youth. The primary aim of this study was to determine patient persistence to antibiotic treatment for group A streptococcus (GAS) pharyngitis in patients presenting with sore throat to the Whangarei Hospital Emergency Department. Secondarily, this study sought to determine prescriber adherence to the national antibiotic guideline for sore throat management...
June 16, 2017: New Zealand Medical Journal
https://www.readbyqxmd.com/read/28617596/review-of-organic-wastewater-compound-concentrations-and-removal-in-onsite-wastewater-treatment-systems
#12
Laurel A Schaider, Kathryn M Rodgers, Ruthann A Rudel
Onsite wastewater treatment systems, such as septic systems, serve 20% of U.S. households and are common in areas not served by wastewater treatment plants (WWTPs) globally. They can be sources of nutrients and pathogen pollution and have been linked to health effects in communities where they contaminate drinking water. However, few studies have evaluated their ability to remove organic wastewater compounds (OWCs) such as pharmaceuticals, hormones, and detergents. We synthesized results from 20 studies of 45 OWCs in conventional drainfield-based and alternative onsite wastewater treatment systems to characterize concentrations and removal...
June 15, 2017: Environmental Science & Technology
https://www.readbyqxmd.com/read/28616291/intensive-blood-pressure-control-in-patients-with-acute-type-b-aortic-dissection-raid-study-protocol-for-randomized-controlled-trial
#13
REVIEW
Jian-Cang Zhou, Nan Zhang, Zhong-Heng Zhang, Ting-Ting Wang, Yue-Feng Zhu, Hui Kang, Wei-Min Zhang, Dong-Lin Li, Wei-Dong Li, Zhen-Jie Liu, Xi-Min Qian, Ming-You Zhang, Jue Wang, Mi Zhou, Zhi-Tao Yang, Yun-Xian Yu, Hang-Yang Li, Jian Zhang, Yong-Gang Wang, Jian-Ping Gao, Lin Ling, Kong-Han Pan
BACKGROUND: Blood pressure control is an essential therapy for patients with acute type B aortic dissection (ABAD) and should be maintained throughout the entire treatment. Thus, vast majority current guidelines recommend control the blood pressure to lower than 140/90 mmHg. Theoretically, a much lower target may further decrease the risk of propagation of dissection. However, some argued that too lower blood pressure would compromise the organ perfusion. Thus, there is no unanimous optimal target for blood pressure in patients with ABAD so far...
May 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28616222/a-case-report-of-an-unusual-cause-of-postoperative-leg-pain-after-posterior-lumbar-fusion
#14
R Daureeawoo, S Baliga, W Mohahmed, E B Ahmed
We report the case of a 36-year old man who underwent elective posterior lumbar spinal fusion after presenting with bilateral leg pain with associated back pain. He had undergone a L5/S1 discectomy in 2001, which provided good symptomatic relief. On this admission, he underwent elective L4-S1 posterolateral fusion and bilateral L4/5 and L5/S1 decompression. Intra-operatively a pedicle screw had to be re-inserted after fluoroscopy confirmed a lateral breech. The patient had no major postoperative complications until the sixth day when the patient re-presented with acute leg pain and weakness...
July 2017: Annals of Medicine and Surgery
https://www.readbyqxmd.com/read/28615932/expanding-the-inspired-copd-outreach-program%C3%A2-to-the-emergency-department-a-feasibility-assessment
#15
Darcy Gillis, Jillian Demmons, Graeme Rocker
BACKGROUND: The Halifax-based INSPIRED COPD Outreach Program™ is a facility-to-community home-based novel clinical initiative that through improved care transitions, self-management, and engagement in advance care planning has demonstrated a significant (60%-80%) reduction in health care utilization with substantial cost aversion. By assessing the feasibility of expanding INSPIRED into the emergency department (ED) we anticipated extending reach and potential for positive impact of INSPIRED to those with acute exacerbation of chronic obstructive pulmonary disease (AECOPD) who avoid hospital admission...
2017: International Journal of Chronic Obstructive Pulmonary Disease
https://www.readbyqxmd.com/read/28615465/emergency-department-urinary-antibiograms-differ-by-specific-patient-groups
#16
S Jorgensen, M Zurayk, S Yeung, J Terry, M Dunn, P Nieberg, A Wong-Beringer
Background: Patients presenting to the ED represent a heterogeneous population comprised of all ages, from the community and skilled-nursing facilities (SNF), and at varying risk for resistant pathogens. The aim of this study was to compare patient group-specific urinary antibiograms in ED.Methods: Adults presented to ED with an ICD 9/10 UTI diagnosis during 7/15 - 6/16 were randomly selected (n=500) to extract relevant demographic, laboratory, and clinical data from the medical record. Urinary E. coli antibiograms were compared between: institutional vs...
June 14, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28615117/impact-of-copd-on-outcomes-in-hospitalized-patients-with-community-acquired-pneumonia-analysis-of-the-spanish-national-hospital-discharge-database-2004-2013
#17
Javier de Miguel-Díez, Ana López-de-Andrés, Valentín Hernández-Barrera, Isabel Jiménez-Trujillo, Manuel Méndez-Bailón, José M de Miguel-Yanes, Rodrigo Jiménez-García
AIM: To examine trends in incidence and outcomes of community-acquired pneumonia (CAP) hospitalizations among patients with or without COPD in Spain (2004-2013). METHODS: We used national hospital discharge data to select all hospital admissions for CAP. Incidence was calculated overall and according to the presence or absence of COPD. RESULTS: We identified 901,136 hospital admissions for CAP (32.25% with COPD). Incidence of hospitalizations of CAP increased significantly over time among patients with and without COPD, but it was higher among people with COPD for all years analyzed...
June 11, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28611875/patient-perspectives-on-accessing-acute-illness-care
#18
Mary K Finta, Amy Borkenhagen, Nicole E Werner, Joyce Duckles, Craig R Sellers, Sandhya Seshadri, Denise Lampo, Manish N Shah
INTRODUCTION: Older adults use the emergency department (ED) at high rates, including for illnesses that could be managed by their primary care providers (PCP). Policymakers have implemented barriers and incentives, often financial, to try to modify use patterns but with limited success. This study aims to understand the factors that influence older adults' decision to obtain acute illness care from the ED rather than from their PCPs. METHODS: We performed a qualitative study using a directed content analysis approach from February to October 2013...
June 2017: Western Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28607037/international-comparison-of-emergency-hospital-use-for-infants-data-linkage-cohort-study-in-canada-and-england
#19
Katie Harron, Ruth Gilbert, David Cromwell, Sam Oddie, Astrid Guttmann, Jan van der Meulen
OBJECTIVES: To compare emergency hospital use for infants in Ontario (Canada) and England. METHODS: We conducted a population-based data linkage study in infants born ≥34 weeks' gestation between 2010 and 2013 in Ontario (n=253 930) and England (n=1 361 128). Outcomes within 12 months of postnatal discharge were captured in hospital records. The primary outcome was all-cause unplanned admissions. Secondary outcomes included emergency department (ED) visits, any unplanned hospital contact (either ED or admission) and mortality...
June 12, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/28606909/-treated-as-a-number-not-treated-as-a-person-a-qualitative-exploration-of-the-perceived-barriers-to-effective-pain-management-of-patients-with-chronic-pain
#20
Muhammad Abdul Hadi, David Phillip Alldred, Michelle Briggs, Kathryn Marczewski, S José Closs
OBJECTIVES: To identify barriers to effective pain management encountered by patients with chronic pain within the UK's National Health Service (NHS). DESIGN: Secondary analysis of face-to-face, semistructured qualitative interviews using thematic analysis. SETTING: A community-based chronic pain clinic jointly managed by a nurse and pharmacist located in the North of England. PARTICIPANTS: Nineteen adult (>18 years) patients with chronic pain discharged from a pain clinic, with the ability to understand and speak the English language...
June 12, 2017: BMJ Open
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