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https://www.readbyqxmd.com/read/28227006/occurrence-of-elevated-shock-index-in-acute-patients-and-development-of-a-proportional-shock-index-metric
#1
Thomas Schmidt, Annmarie Lassen, Uffe Kock Wiil, Thomas Schmidt, Annmarie Lassen, Uffe Kock Wiil, Uffe Kock Wiil, Thomas Schmidt, Annmarie Lassen
Although shock index, as the ratio between heart rate and systolic blood pressure, is a well-recognized predictor for adverse outcomes, it is seldom integrated into clinical evaluation procedures as it requires on-the-fly evaluation of multiple terms. In this paper, we investigate the prevalence of elevated shock index in emergency department patients through an analysis of automatic heart rate and blood pressure readings from 809 admissions to an acute bedside ward at a large Danish hospital. The analysis is conducted by evaluating differences in terms of 30 day mortality...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226561/feasibility-of-unobstrusive-ambient-sensors-for-fall-detections-in-home-environment
#2
Qing Zhang, Mohan Karunanithi, Qing Zhang, Mohan Karunanithi, Mohan Karunanithi, Qing Zhang
Falls are the leading threats of death, injury and hospital admissions of seniors. About one third of seniors fall every year. Real time fall detection is thus critical to support independent livings of seniors by getting timely interventions from carers/family members. Recent years along with the IoT booming, many wearable sensor based fall detection systems have been developed. However privacy concerns or simply forgot-to-wear make wearable sensors not very accepted by seniors in a home environment seeking long term monitoring solutions...
August 2016: Conference Proceedings: Annual International Conference of the IEEE Engineering in Medicine and Biology Society
https://www.readbyqxmd.com/read/28226329/transfrontal-and-transsphenoidal-approaches-to-pediatric-craniopharyngioma-a-national-perspective
#3
Yimo Lin, Daniel Hansen, Christina M Sayama, I-Wen Pan, Sandi Lam
INTRODUCTION: This study compared transsphenoidal (TS) and transfrontal (TF) approaches to craniopharyngioma utilizing a national database. METHODS: The Kids' Inpatient Database (2003, 2006, and 2009) was surveyed for patients with a diagnosis of craniopharyngioma who underwent a subset of surgical interventions to compare TS and TF surgery. Demographics, hospital variables, and complications/comorbidities were analyzed with multivariate regression. RESULTS: 314 admissions (TS = 104, TF = 210) were identified...
February 23, 2017: Pediatric Neurosurgery
https://www.readbyqxmd.com/read/28225563/self-selection-bias-in-eating-disorders-outcomes-research-does-treatment-response-of-underweight-research-participants-and-non-participants-differ
#4
Colleen C Schreyer, Graham W Redgrave, Jennifer L Hansen, Angela S Guarda
Observational treatment studies provide a valuable alternative to RCTs but are often criticized due to potential self-selection biases. Studies comparing those who do and do not participate in research on eating disorder treatment are scarce, but necessary to evaluate the impact of self-selection bias on outcomes. All consecutive underweight adult first admissions (N = 392) to an integrated inpatient (IP)-partial hospital (PH) behavioral specialty program were invited to participate in a longitudinal study of eating disorder treatment...
February 22, 2017: International Journal of Eating Disorders
https://www.readbyqxmd.com/read/28225500/the-prevalence-of-potentially-preventable-deaths-in-an-acute-care-hospital-a-retrospective-cohort
#5
Daniel M Kobewka, Carl van Walraven, Monica Taljaard, Paul Ronksley, Alan J Forster
Studies estimate that 6% to 27% of deaths in hospitals might be prevented with higher quality care. These estimates may be inaccurate because they fail to account for the uncertainty associated with classifying preventability. The purpose of this study was to measure the prevalence of preventable deaths, accounting for the uncertainty in preventability ratings.We created standardized structured case abstracts for all deaths at a multisite academic teaching hospital over a 3-month period. Each case abstract was evaluated independently by 4 reviewers who rated death preventability on a 100-point scale ranging from 0 ("Definitely not preventable") to 100 ("Definitely preventable")...
February 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28225386/acute-myocardial-infarction-and-antiphospholipid-antibody-syndrome-a-systematic-review
#6
Salik Nazir, Niranjan Tachamo, Saroj Lohani, Rittu Hingorani, Dilli R Poudel, Anthony Donato
BACKGROUND: Antiphospholipid antibody syndrome (APS) is a disorder associated with both arterial and venous thromboembolic disease, including acute myocardial infarction (AMI). Given that management with anticoagulants is critical and differs from usual AMI care, identification of key discriminators of patients with AMI with APS is important. METHODS: We performed an English-language systematic review of the literature of cases and case series of patients with AMI and APS from inception until 20 March 2016, collecting demographics, investigations, and outcomes...
February 20, 2017: Coronary Artery Disease
https://www.readbyqxmd.com/read/28225051/low-muscle-mass-at-initiation-of-anti-tnf-therapy-for-inflammatory-bowel-disease-is-associated-with-early-treatment-failure-a-retrospective-analysis
#7
D Q Holt, P Varma, B J G Strauss, A S Rajadurai, G T Moore
BACKGROUND/OBJECTIVES: Delayed treatment failure occurs in a significant proportion of inflammatory bowel disease (IBD) patients treated with tumor necrosis factor-alpha (TNF) antagonists. Identification of predictors of loss of response (LOR) may help to optimize therapy. We sought to determine whether body composition parameters at the commencement of anti-TNF therapy were associated with earlier treatment failure. SUBJECTS/METHODS: A retrospective cohort study was performed on 68 patients who had undergone cross-sectional abdominal imaging coincident with the commencement of anti-TNF drugs...
February 22, 2017: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/28225001/phosphodiesterase-4d-polymorphisms-associate-with-the-short-term-outcome-in-ischemic-stroke
#8
Yan-Li Song, Chun-Juan Wang, Yi-Ping Wu, Jie Lin, Peng-Lian Wang, Wan-Liang Du, Li Liu, Jin-Xi Lin, Yi-Long Wang, Yong-Jun Wang, Gai-Fen Liu
It has been demonstrated that phosphodiesterase 4D (PDE4D) genetic polymorphism is associated with ischemic stroke. However, the association between PDE4D gene and prognosis after ischemic stroke remains unknown. We consecutively enrolled ischemic stroke patients admitted to Beijing Tiantan Hospital from October 2009 to December 2013. Clinical, laboratory and imaging data upon admission were collected. All patients were followed up 3 months after stroke onset. Odds ratios (ORs) and 95% confidence intervals (CIs) were calculated to assess the associations of genetic polymorphisms with 3-month outcome after ischemic stroke and different subtypes, under various genetic models...
February 22, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28224873/-mrsa-infection-via-a-staff-member-with-eczema
#9
B P Overbeek, W E A Maathuis-de Haan, G Stoffer
BACKGROUND: Transmission of MRSA from livestock to humans is rare, but it is advisable to remain alert. CASE STUDY: Following 2 hospital admissions within a month and a half, a 73-year-old patient was found to have become infected with MRSA. The MRSA type was livestock-related. Investigations into contact between the patient and staff revealed that 3 staff members were infected with the same bacteria; one of them had eczema on both hands. Her daughter, who worked intensively with horses, was revealed to be a carrier of the same type of MRSA...
2017: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/28224346/dedication-increases-productivity-an-analysis-of-the-implementation-of-a-dedicated-medical-team-in-the-emergency-department
#10
Pedro Ramos, José Artur Paiva
BACKGROUND: In several European countries, emergency departments (EDs) now employ a dedicated team of full-time emergency medicine (EM) physicians, with a distinct leadership and bed-side emergency training, in all similar to other hospital departments. In Portugal, however, there are still two very different models for staffing EDs: a classic model, where EDs are mostly staffed with young inexperienced physicians from different medical departments who take turns in the ED in 12-h shifts and a dedicated model, recently implemented in some hospitals, where the ED is staffed by a team of doctors with specific medical competencies in emergency medicine that work full-time in the ED...
December 2017: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28224127/early-diagnosis-and-surgical-treatment-for-necrotizing-fasciitis-a-multicenter-study
#11
Evangelos P Misiakos, George Bagias, Iordanis Papadopoulos, Nickolaos Danias, Paul Patapis, Nickolaos Machairas, Theodore Karatzas, Nickolaos Arkadopoulos, Konstantinos Toutouzas, Nickolaos Alexakis, Manousos N Konstantoulakis, George Zografos, Vasilis Smyrniotis, Gregory Kouraklis, Anastasios Machairas
BACKGROUND: Necrotizing fasciitis (NF) is a group of relatively rare infections, usually caused by two or more pathogens. It affects the skin and subcutaneous tissues of lower and upper limbs, perineal area (Fournier's gangrene), and the abdominal wall. Early diagnosis and aggressive surgical management are of high significance for the management of this potentially lethal disease. METHODS: We conducted a retrospective study in patients who presented, during the last decade, at four University Surgical Departments in the area of Athens, Greece, with an admission diagnosis of NF...
2017: Frontiers in Surgery
https://www.readbyqxmd.com/read/28224108/implementation-of-enteral-feeding-protocol-in-an-intensive-care-unit-before-and-after-study
#12
Martin Padar, Gerli Uusvel, Liis Starkopf, Joel Starkopf, Annika Reintam Blaser
AIM: To determine the effects of implementing an enteral feeding protocol on the nutritional delivery and outcomes of intensive care patients. METHODS: An uncontrolled, observational before-and-after study was performed in a tertiary mixed medical-surgical intensive care unit (ICU). In 2013, a nurse-driven enteral feeding protocol was developed and implemented in the ICU. Nutrition and outcome-related data from patients who were treated in the study unit from 2011-2012 (the Before group) and 2014-2015 (the After group) were obtained from a local electronic database, the national Population Registry and the hospital's Infection Control Service...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28224105/nutrient-stimulation-of-mesenteric-blood-flow-implications-for-older-critically-ill-patients
#13
REVIEW
Thu An Nguyen, Yasmine Ali Abdelhamid, Liza K Phillips, Leeanne S Chapple, Michael Horowitz, Karen L Jones, Adam M Deane
Nutrient ingestion induces a substantial increase in mesenteric blood flow. In older persons (aged ≥ 65 years), particularly those with chronic medical conditions, the cardiovascular compensatory response may be inadequate to maintain systemic blood pressure during mesenteric blood pooling, leading to postprandial hypotension. In older ambulatory persons, postprandial hypotension is an important pathophysiological condition associated with an increased propensity for syncope, falls, coronary vascular events, stroke and death...
February 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28224093/pediatric-asthma-severity-score-is-associated-with-critical-care-interventions
#14
Danielle K Maue, Nadia Krupp, Courtney M Rowan
AIM: To determine if a standardized asthma severity scoring system (PASS) was associated with the time spent on continuous albuterol and length of stay in the pediatric intensive care unit (PICU). METHODS: This is a single center, retrospective chart review study at a major children's hospital in an urban location. To qualify for this study, participants must have been admitted to the PICU with a diagnosis of status asthmaticus. There were a total of 188 participants between the ages of two and nineteen, excluding patients receiving antibiotics for pneumonia...
February 8, 2017: World Journal of Clinical Pediatrics
https://www.readbyqxmd.com/read/28223786/factors-involved-in-the-discontinuation-of-oral-intake-in-elderly-patients-with-recurrent-aspiration-pneumonia-a-multicenter-study
#15
Tsuneaki Kenzaka, Taro Takeshima, Koki Kosami, Ayako Kumabe, Yuki Ueda, Takeshi Takahashi, Yuya Yamamoto, Yurika Hayashi, Akihito Kitao, Masanobu Okayama
PURPOSE: To assess the factors involved in oral intake discontinuation in elderly patients with recurrent aspiration pneumonia. PATIENTS AND METHODS: This study included patients with pneumonia who were treated at Jichi Medical University Hospital between 2007 and 2013, at Toyooka Public Hospital between 2011 and 2013 and at Yuzawa Community Medical Center between 2010 and 2012. We consecutively enrolled patients with aspiration pneumonia. The primary study point was oral intake discontinuation after the initiation of oral intake during hospitalization in cases of recurrent aspiration...
2017: Clinical Interventions in Aging
https://www.readbyqxmd.com/read/28223463/impact-of-a-respiratory-therapy-assess-and-treat-protocol-on-adult-cardiothoracic-icu-readmissions
#16
Robert T Dailey, Thomas Malinowski, Mitchel Baugher, Daniel D Rowley
BACKGROUND: The purpose of this retrospective medical record review was to report on recidivism to the ICU among adult postoperative cardiac and thoracic patients managed with a respiratory therapy assess-and-treat (RTAT) protocol. Our primary null hypothesis was that there would be no difference in all-cause unexpected readmissions and escalations between the RTAT group and the physician-ordered respiratory care group. Our secondary null hypothesis was that there would be no difference in primary respiratory-related readmissions, ICU length of stay, or hospital length of stay...
February 21, 2017: Respiratory Care
https://www.readbyqxmd.com/read/28223175/high-fatality-rates-and-associated-factors-in-two-hospital-outbreaks-of-mers-in-daejeon-the-republic-of-korea
#17
Hae-Sung Nam, Jung Wan Park, Moran Ki, Mi-Yeon Yeon, Jin Kim, Seung Woo Kim
OBJECTIVES: To explore the epidemiological and clinical factors predictive of the case fatality rate (CFR) of Middle East respiratory syndrome-coronavirus (MERS-CoV) infection in an outbreak in Daejeon, the Republic of Korea. METHODS: We reviewed the outbreak investigation reports and medical records of 1 index case and 25 additional MERS cases in hospitals A (14 cases) and B (11 cases), and conducted an in-depth interview with the index case. RESULTS: The CFR in hospital B was higher than that in hospital A (63...
February 18, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/28222988/thirty-day-and-90-day-hospital-readmission-after-outpatient-upper-extremity-hemodialysis-access-creation
#18
Jeffrey J Siracuse, Nishant K Shah, Matthew R Peacock, Georges Tahhan, Jeffrey A Kalish, Denis Rybin, Mohammad H Eslami, Alik Farber
OBJECTIVE: Patients with end-stage renal disease have multiple comorbidities and are at increased risk for postoperative complications and resource utilization. Our goal was to determine the rate and causes of 30-day and 90-day hospital readmissions after the creation of outpatient hemodialysis access. METHODS: We retrospectively reviewed all outpatient upper extremity hemodialysis access creations performed at our medical center from 2008 to 2015. Readmission was defined as any inpatient status admission ≤30 and 90 days...
February 17, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28222896/comparison-of-the-prognostic-value-of-chronic-liver-failure-consortium-scores-and-traditional-models-for-predicting-mortality-in-patients-with-cirrhosis
#19
Artur Gião Antunes, Cristina Teixeira, Ana Margarida Vaz, Cláudio Martins, Patrícia Queirós, Ana Alves, Francisco Velasco, Bruno Peixe, Ana Paula Oliveira, Horácio Guerreiro
BACKGROUND AND AIM: Recently, the European Association for the Study of the Liver - Chronic Liver Failure (CLIF) Consortium defined two new prognostic scores, according to the presence or absence of acute-on-chronic liver failure (ACLF): the CLIF Consortium ACLF score (CLIF-C ACLFs) and the CLIF-C Acute Decompensation score (CLIF-C ADs). We sought to compare their accuracy in predicting 30- and 90-day mortality with some of the existing models: Child-Turcotte-Pugh (CTP), Model for End-Stage Liver Disease (MELD), MELD-Na, integrated MELD (iMELD), MELD to serum sodium ratio index (MESO), Refit MELD and Refit MELD-Na...
February 17, 2017: Gastroenterología y Hepatología
https://www.readbyqxmd.com/read/28222830/impact-of-early-vasopressor-administration-on-neurological-outcomes-after-prolonged-out-of-hospital-cardiac-arrest
#20
Michael W Hubble, Clark Tyson
: Introduction Vasopressors are associated with return of spontaneous circulation (ROSC), but no long-term benefit has been demonstrated in randomized trials. However, these trials did not control for the timing of vasopressor administration which may influence outcomes. Consequently, the objective of this study was to develop a model describing the likelihood of favorable neurological outcome (cerebral performance category [CPC] 1 or 2) as a function of the public safety answering point call receipt (PSAP)-to-pressor-interval (PPI) in prolonged out-of-hospital cardiac arrest...
February 22, 2017: Prehospital and Disaster Medicine
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