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https://www.readbyqxmd.com/read/28737996/integrating-palliative-and-oncology-care-for-patients-with-advanced-cancer-a-quality-improvement-intervention
#1
Laura C Hanson, Frances Collichio, Stephen A Bernard, William A Wood, Matt Milowsky, Erin Burgess, Crista J Creedle, Summer Cheek, Lydia Chang, Bhisham Chera, Alexandra Fox, Feng-Chang Lin
BACKGROUND: Practice guidelines recommend palliative care for patients with advanced cancer, but gaps in access and quality of care persist. OBJECTIVE: To increase goals-of-care (GOC) communication for hospitalized patients with Stage IV cancer. METHODS: An interdisciplinary team designed a quality improvement intervention to enhance oncology palliative care, including training in communication skills and triggers for palliative care consults...
July 24, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28737864/measuring-adverse-events-in-pediatric-inpatients-with-the-global-trigger-tool
#2
María C Davenport, Paula A Domínguez, Juan P Ferreira, Ana L Kannemann, Agustina Paganini, Fernando A Torres
INTRODUCTION: The safety of inpatients is a priority in the health care system. The Global Trigger Tool seems to be suitable to estimate the incidence of adverse events (AE) in pediatric inpatients. OBJETIVES: To describe the incidence and categories of AE in pediatric inpatients using the Global Trigger Tool and to identify risk factors associated to their development. POPULATION AND METHODS: Retrospective study. Medical records of 200 patients hospitalized at Hospital Elizalde during 2013 were included...
August 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28737647/risk-factors-for-30-day-hospital-readmission-for-diverticular-hemorrhage
#3
Jonah N Rubin, Daniel Shoag, John N Gaetano, Dejan Micic, Neil Sengupta
INTRODUCTION: The 2010 Affordable Care Act introduced the Hospital Readmissions Reduction Program to reduce health care utilization. Diverticular disease and its complications remain a leading cause of hospitalization among gastrointestinal disease. We sought to determine risk factors for 30-day hospital readmissions after hospitalization for diverticular bleeding. MATERIALS AND METHODS: We utilized the 2013 National Readmission Database sponsored by the Agency for Healthcare Research and Quality focusing on hospitalizations with the primary or secondary discharge diagnosis of diverticular hemorrhage or diverticulitis with hemorrhage...
July 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28737646/crp-albumin-ratio-an-early-predictor-of-steroid-responsiveness-in-acute-severe-ulcerative-colitis
#4
David J Gibson, Karen Hartery, Jayne Doherty, Jack Nolan, Denise Keegan, Kathryn Byrne, Sean T Martin, Maire Buckley, Juliette Sheridan, Gareth Horgan, Hugh E Mulcahy, Garret Cullen, Glen A Doherty
INTRODUCTION: Identifying hospitalized patients with acute severe ulcerative colitis (ASUC) who will be refractory to corticosteroid therapy and require rescue therapy remains difficult. Hypoalbuminemia worsens with time during hospitalization and is associated with rapid clearance of and reduced response to infliximab (IFX) rescue. Early use of rescue therapy may therefore be more effective. Simple clinical and laboratory predictors of corticosteroid responsiveness would facilitate earlier use of rescue therapy...
July 21, 2017: Journal of Clinical Gastroenterology
https://www.readbyqxmd.com/read/28737622/changes-in-the-nature-and-severity-of-invasive-pneumococcal-disease-in-children-before-and-after-the-7-valent-and-13-valent-pneumococcal-conjugate-vaccine-programs-in-calgary-canada
#5
Leah J Ricketson, Nicholas G Conradi, Otto G Vanderkooi, James D Kellner
BACKGROUND: Since the introduction of childhood pneumococcal conjugate vaccines, invasive pneumococcal disease (IPD) incidence has decreased in children and the predominant serotypes causing disease have changed. This study describes changes in the clinical features of IPD in children (<18 years) before and after conjugate vaccine introduction. METHODS: The Calgary Area Streptococcus pneumoniae Epidemiology Research (CASPER) study collects information on all IPD cases in Calgary, Alberta, Canada...
July 20, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/28737598/epidemiology-and-outcomes-of-cardiac-arrest-in-pediatric-cardiac-icus
#6
Jeffrey A Alten, Darren Klugman, Tia T Raymond, David S Cooper, Janet E Donohue, Wenying Zhang, Sara K Pasquali, Michael G Gaies
OBJECTIVES: In-hospital cardiac arrest occurs in 2.6-6% of children with cardiac disease and is associated with significant morbidity and mortality. Much remains unknown about cardiac arrest in pediatric cardiac ICUs; therefore, we aimed to describe cardiac arrest epidemiology in a contemporary multicenter cardiac ICU cohort. DESIGN: Retrospective analysis within the Pediatric Cardiac Critical Care Consortium clinical registry. SETTING: Cardiac ICUs within 23 North American hospitals...
July 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28737597/a-prospective-study-of-the-association-between-clinically-significant-bleeding-in-picu-patients-and-thrombocytopenia-or-prolonged-coagulation-times
#7
Paul C Moorehead, Nicholas J Barrowman, Janelle Cyr, Jamie Ray, Robert Klaassen, Kusum Menon
OBJECTIVE: There are no proven methods to predict the risk of clinically significant bleeding in the PICU. A retrospective study identified platelet count as a risk marker for clinically significant bleeding. We conducted a study to examine any association of platelet count, international normalized ratio, and activated partial thromboplastin time with bleeding risk in PICU patients. DESIGN: Prospective observational cohort study. SETTING: The PICU at the Children's Hospital of Eastern Ontario, a university-affiliated tertiary care pediatric center...
July 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28737574/is-there-a-role-for-enterohormones-in-the-gastroparesis-of-critically-ill-patients
#8
Carlos A Santacruz, Amanda Quintairos, Claudia Righy, Ilaria A Crippa, Lucio Couto, Virginie Imbault, Mongkolpun Wasineeart, Mathieu De Ryckere, Jean-Charles Preiser
OBJECTIVES: Delayed gastric emptying occurs in critically ill patients and impairs the delivery, digestion, and absorption of enteral feeding. A pathophysiologic role of the enterohormones peptide YY and ghrelin is supported by preclinical data. To compare the circulating plasma levels of peptide YY and ghrelin in control subjects and in critically ill patients, during feeding and fasting, and to search for a correlation with gastric emptying. DESIGN: A prospective observational trial...
July 21, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28737563/reverse-distal-transverse-palmar-arch-in-distal-digital-replantation
#9
Ching-Yueh Wei, Oscar Orozco, Gustavo Vinagre, Mark Shafarenko
BACKGROUND: Refinements in microsurgery have made distal finger replantation an established technique with high success rates and good functional and aesthetic outcomes. However, it still represents a technically demanding procedure due to the small vessel caliber and frequent lack of vessel length, requiring the use of interpositional venous grafts in some instances. We describe a new technique for anastomosis in fingertip replantation, whereby the need for venous grafts is eliminated...
July 22, 2017: Annals of Plastic Surgery
https://www.readbyqxmd.com/read/28737266/nephrolithiasis-a-complication-of-pediatric-diabetic-ketoacidosis
#10
Sungeeta Agrawal, Robin Kremsdorf, Serife Uysal, Meghan E Fredette, Lisa Swartz Topor
OBJECTIVE: To determine the frequency of nephrolithiasis as a complication of diabetic ketoacidosis (DKA) in pediatrics. METHODS: We performed a retrospective chart review of patients with DKA admitted to a pediatric hospital between January 2009 and July 2016. We identified patients with nephrolithiasis during admission for DKA. RESULTS: We identified 395 episodes of DKA over 7.5 years. Nephrolithiasis developed as a complication of DKA in 3 of those admissions (0...
July 24, 2017: Pediatric Diabetes
https://www.readbyqxmd.com/read/28737234/formula-supplementation-in-hospital-and-subsequent-feeding-at-discharge-among-women-who-intended-to-exclusively-breastfeed-an-administrative-data-retrospective-cohort-study
#11
Jason P Bentley, Natasha Nassar, Maree Porter, Michelle de Vroome, Elizabeth Yip, Amanda J Ampt
BACKGROUND: Among women who intend to exclusively breastfeed, it is important to identify mothers and their infants who have a greater risk of formula supplementation in hospital, and are unlikely to recover exclusive breastfeeding at discharge. We investigated factors associated with in-hospital formula feeding among healthy term infants born to women who intended to exclusively breastfeed, and among this group, predictors of infant feeding at discharge. METHODS: Retrospective cohort study utilizing routinely collected clinical data for women who intended to exclusively breastfeed and gave birth to healthy term infants in five hospitals in New South Wales, Australia, 2010-2013...
July 24, 2017: Birth
https://www.readbyqxmd.com/read/28737191/-stress-in-parents-of-hospitalized-newborns-in-a-neonatal-intensive-care-unit
#12
Elisa Palma I, Fernanda Von Wussow K, Ignacia Morales B, Javier Cifuentes R, Sergio Ambiado T
The birth of a child that requires hospitalization in a Neonatal Intensive Care Unit (NICU) can be very stressful for parents. OBJECTIVE: To determine the stress level of parents of newborns (NB) hospitalized in a level III NICU in Santiago, and its association with clinical and sociodemographic variables. PATIENTS AND METHOD: Descriptive cross-sectional study. 373 admissions were evaluated. The sampling was non-probabilistic and included parents of RN admitted to the UPCN between 7 and 21 days of hospitalization...
June 2017: Revista Chilena de Pediatría
https://www.readbyqxmd.com/read/28737073/bleeding-pelvic-fracture-patients-evolution-of-resuscitation-protocols
#13
T Söderlund, T Ketonen, L Handolin
BACKGROUND AND AIMS: Massive transfusion protocol seems to improve outcome in massively bleeding trauma patients, but not pelvic fracture patients. The aim of this study was to evaluate the effect of massive transfusion protocol on the mortality and fluid resuscitation of shocked pelvic fracture patients. MATERIAL AND METHODS: This is a trauma register study from a single hospital. From the trauma registry patients with pelvic fracture, injury severity score >15, admission base excess below -5, age >15 years, blunt trauma, and primary admission from the scene were identified...
March 1, 2017: Scandinavian Journal of Surgery: SJS
https://www.readbyqxmd.com/read/28737066/%C3%AE-blockade-in-heart-failure-with-reduced-ejection-fraction-does-heart-rate-control-influence-readmissions
#14
Ryan E Owens, Jennifer D Twilla, Timothy H Self, Abdulrahman I Alshaya, Carlvin J Metra, Carolyn Cummings, Carrie S Oliphant
BACKGROUND: Raised resting heart rate (HR), >70 beats per minute (bpm), has been shown to be a risk factor for adverse cardiovascular outcomes and hospital readmissions, specifically in patients with heart failure with reduced ejection fraction (HF rEF). Given their mortality benefit, β-blockers are recommended in HF rEF, with a goal to titrate to a maximum tolerated dose rather than a specific HR target. OBJECTIVE: To determine the impact of optimal HR control achievement prior to hospital discharge on hospital readmissions in patients with HF rEF receiving β-blockade...
January 1, 2017: Journal of Pharmacy Practice
https://www.readbyqxmd.com/read/28737025/-influence-of-initial-protocolized-treatment-with-steroids-in-length-of-stay-and-costs-of-community-acquired-pneumonia
#15
J Gómez Gómez, J L Gómez Torres, A Hernández Torres, J A García Córdoba, M Canteras Jordana
OBJECTIVE: The aim of the study was to analyze the impact of steroid treatment in patients with community acquired pneumonia (CAP), both in length of stay and economical cost of admission at a clinical university hospital. METHODS: Prospective study of admitted patients with the diagnosis of CAP, both in Internal Medicine and Infectious diseases department. The study was conducted from January to march 2015; patients receiving steroids from diagnosis to end of antibiotic treatment were classified as group I; otherwise, they were considered in group II...
July 24, 2017: Revista Española de Quimioterapia: Publicación Oficial de la Sociedad Española de Quimioterapia
https://www.readbyqxmd.com/read/28736972/reduced-risk-of-emergency-admission-for-colorectal-cancer-associated-with-introduction-of-bowel-cancer-screening-across-england-retrospective-national-cohort-study
#16
J Geraghty, M Shawihdi, E Devonport, S Sarkar, M G Pearson, K Bodger
AIM: We examined whether roll out of the bowel cancer screening programme (BCSP) across England was associated with a reduced risk of emergency hospital admission for people presenting with colorectal cancer (CRC) during this period. METHOD: This is a retrospective cohort study of 27,763 incident cases of CRC over a 1-year period during the roll-out of screening across parts of England. The primary outcome was the number of emergency (unplanned) hospital admissions during the diagnostic pathway...
July 24, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28736760/self-harm-and-violent-criminality-among-young-people-who-experienced-trauma-related-hospital-admission-during-childhood-a-danish-national-cohort-study
#17
Roger T Webb, Sussie Antonsen, Matthew J Carr, Louis Appleby, Carsten B Pedersen, Pearl L H Mok
BACKGROUND: Development of a better understanding of subsequent pathways for individuals who experienced trauma during childhood might usefully inform clinicians and public health professionals regarding the causes of self-harm and interpersonal violence. We aimed to examine these risks during late adolescence and early adulthood among people admitted to hospital following injuries or poisonings during their childhood. METHODS: This national cohort study included Danish people born between Jan 1, 1977, and Dec 31, 1997, and was linked to the National Patient Register and Psychiatric Central Research Register to identify all people exposed to hospital admissions for injuries or poisonings due to self-harm, interpersonal violence, or accidents before their 15th birthday...
July 2017: Lancet. Public Health
https://www.readbyqxmd.com/read/28736045/comparative-effectiveness-of-high-dose-versus-standard-dose-influenza-vaccination-on-numbers-of-us-nursing-home-residents-admitted-to-hospital-a-cluster-randomised-trial
#18
Stefan Gravenstein, H Edward Davidson, Monica Taljaard, Jessica Ogarek, Pedro Gozalo, Lisa Han, Vincent Mor
BACKGROUND: Immune responses to influenza vaccines decline with age, reducing clinical effectiveness. We compared the effect of the more immunogenic high-dose trivalent influenza vaccine with a standard-dose vaccine to identify the effect on reducing hospital admissions of nursing home residents in the USA. METHODS: We did a single-blind, pragmatic, comparative effectiveness, cluster-randomised trial with a 2 × 2 factorial design. Medicare-certified nursing homes in the USA located within 50 miles of a Centers for Disease Control and Prevention influenza reporting city were recruited, so long as the facilities were not located in a hospital, had more than 50 long-stay residents, had less than 20% of the population aged under 65 years, and were not already planning to administer the high-dose influenza vaccine to residents...
July 20, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28735722/-is-the-introduction-of-clinical-management-programs-for-patients-with-chronic-obstructive-pulmonary-disease-useful-comparison-of-the-effectiveness-of-two-interventions-on-the-clinical-progress-and-care-received
#19
Ingrid Solanes, Ignasi Bolíbar, Maria Antònia Llauger, Meritxell Peiro, Pepi Valverde, Mar Fraga, Casimira Medrano, Teresa Bigorra, Montserrat Freixas, Iskra Ligüerre, Maria Antònia Pou, Leandra Domínguez, Carles Valero, Judit Solà, Jordi Giner, Vicente Plaza
OBJECTIVE: To evaluate the effectiveness of two management programs on patients with chronic obstructive pulmonary disease (COPD). DESIGN: A study with a quasi-experimental design was used to evaluate the effectiveness of two interventions (I1, I2) for the care of patients with COPD after a mean follow-up of 31.2months. SETTING: Primary Care Centres in two Barcelona Health Areas and their referral hospitals. PARTICIPANTS: Patients with COPD selected by simple random sampling using any disease code corresponding to COPD...
July 20, 2017: Atencion Primaria
https://www.readbyqxmd.com/read/28735268/early-surgery-and-neurodevelopmental-outcomes-of-children-born-extremely-preterm
#20
Rodney W Hunt, Leah M Hickey, Alice C Burnett, Peter J Anderson, Jeanie Ling Yoong Cheong, Lex W Doyle, Rodney W Hunt
OBJECTIVES: To (1) compare the neurodevelopmental outcomes at 8 years of age of children born extremely preterm (EP) who underwent surgical procedures during the course of their initial hospital admission with those who did not and (2) compare the outcomes across eras, from 1991 to 2005. DESIGN: Prospective observational cohort studies conducted over three different eras (1991-1992, 1997 and 2005). Surviving EP children, who required surgical intervention during the primary hospitalisation, were assessed for general intelligence (IQ) and neurosensory status at 8 years of age...
July 22, 2017: Archives of Disease in Childhood. Fetal and Neonatal Edition
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