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https://www.readbyqxmd.com/read/28102937/re-implementation-of-an-evidence-based-acute-tonsillitis-protocol-our-experience-in-one-hundred-and-twenty-six-patients
#1
Guled M Jama, Mahmoud Nosseir, Julian Danino, James Barraclough
The 'Portsmouth Tonsillitis Protocol' by Bird et al. (October 2013 issue)([1]) provides the first published treatment algorithm for use in patients with acute tonsillitis presenting to secondary care. Following introduction of the protocol at their centre the authors demonstrate an improved delivery of tonsillitis treatment as well as a reduction in hospital admission rates and inpatient services leading to significant cost savings. The financial implications are particularly relevant to health services facing economic pressures...
January 19, 2017: Clinical Otolaryngology
https://www.readbyqxmd.com/read/28102899/b-type-natriuretic-peptide-guided-treatment-for-heart-failure
#2
REVIEW
Julie McLellan, Carl J Heneghan, Rafael Perera, Alison M Clements, Paul P Glasziou, Karen E Kearley, Nicola Pidduck, Nia W Roberts, Sally Tyndel, F Lucy Wright, Clare Bankhead
BACKGROUND: Heart failure is a condition in which the heart does not pump enough blood to meet all the needs of the body. Symptoms of heart failure include breathlessness, fatigue and fluid retention. Outcomes for patients with heart failure are highly variable; however on average, these patients have a poor prognosis. Prognosis can be improved with early diagnosis and appropriate use of medical treatment, use of devices and transplantation. Patients with heart failure are high users of healthcare resources, not only due to drug and device treatments, but due to high costs of hospitalisation care...
December 22, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28102889/a-population-based-study-examining-injury-in-older-adults-with-and-without-dementia
#3
Lynn B Meuleners, Michelle B Hobday
OBJECTIVES: To estimate the incidence of and risk factors for injuries in older adults with and without dementia. DESIGN: Retrospective, population-based cohort study. SETTING: Western Australian Data Linkage System (WADLS). PARTICIPANTS: Cases included 29,671 (47.9%) older adults aged 50 and older with an index hospital admission for dementia between 2001 and 2011. Comparison participants without dementia included a random sample of 32,277 (52...
January 19, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28101900/bronchial-thermoplasty-in-severe-asthma-in-australia
#4
David Langton, Joy Sha, Alvin Ing, David Fielding, Erica Wood
BACKGROUND: Bronchial thermoplasty is an approved bronchoscopic intervention for the treatment of severe asthma. However, limited published experience exists outside of clinical trials regarding patient selection and outcomes achieved. Aims To evaluate the effectiveness and safety of bronchial thermoplasty in patients with severe asthma encountered in clinical practice. METHODS: This is a retrospective analysis of the first 'real world' data from Australia. The following outcomes were measured prior to, and 6 months following bronchial thermoplasty: Spirometry, Asthma Control Questionnaire-5 (ACQ-5) score, reliever and preventer medication use, and exacerbation history...
January 19, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28101483/intermittent-theta-slowings-in-contralateral-side-of-weakness-after-sleep-deprivation-on-spot-eeg-in-sporadic-hemiplegic-migraine
#5
Chan-Hyuk Lee, Man-Wook Seo, Byoung-Soo Shin, Tae-Ho Yang, Hyun-June Shin, Han Uk Ryu
Hemiplegic migraine (HM) is an uncommon type of migraine which is classified into sporadic and familial subtype. The noticed electroencephalogram (EEG) findings during HM attack are diffuse slowing contralateral to the weakened limb, but are usually normal in asymptomatic states. A 52-year-old woman who suffered from headache accompanying right arm weakness and aphasic symptoms admitted to our hospital. She underwent total five times of EEG including 2 times before admission. Only the last EEG exam after 24 hours of sleep deprivation (SD) showed intermittent slowing and higher amplitude of positive occipital sharp transients (POSTs) on the left parieto-occipital area...
December 2016: Journal of Epilepsy Research
https://www.readbyqxmd.com/read/28101187/severe-pneumonia-due-to-infection-with-candida-krusei-in-a-case-of-suspected-middle-east-respiratory-syndrome-a-case-report-and-literature-review
#6
Mingming Tan, Junwei Wang, Peiyang Hu, Bin Wang, Wanghua Xu, Jiao Chen
Candida krusei (C. krusei) pneumonia is a rare infection that is frequently associated with a poor outcome. The present study reports an unusual case of C. krusei pneumonia that was initially suspected to be a Middle East respiratory syndrome (MERS) case. A 64-year-old Saudi Arabian male patient was admitted to our hospital with complaints of cough and dyspnea that persisted for 6 days. The patient presented fever (oral temperature, 38.5°C) and slight tachypnea (25 respirations/min). A chest computerized tomography demonstrated unclear lung fields, diffuse pathological changes in the two lungs and multiple lymphadenectasis in the retrocaval and para-aortic arch area...
December 2016: Experimental and Therapeutic Medicine
https://www.readbyqxmd.com/read/28101125/preventive-transarterial-embolization-in-upper-nonvariceal-gastrointestinal-bleeding
#7
Aleksejs Kaminskis, Aina Kratovska, Sanita Ponomarjova, Anna Tolstova, Maksims Mukans, Solvita Stabiņa, Raivis Gailums, Andrejs Bernšteins, Patricija Ivanova, Viesturs Boka, Guntars Pupelis
BACKGROUND: Transarterial embolization (TAE) is a therapeutic option for patients with a high risk of recurrent bleeding after endoscopic haemostasis. The aim of our prospective study was a preliminary assessment of the safety, efficacy, and clinical outcomes following preventive TAE in patients with non-variceal acute upper gastrointestinal bleeding (NVUGIB) with a high risk of recurrent bleeding after endoscopic haemostasis. METHODS: Preventive visceral angiography and TAE were performed after endoscopic haemostasis on patients with NVUGIB who were at a high risk of recurrent bleeding (PE+ group)...
2017: World Journal of Emergency Surgery: WJES
https://www.readbyqxmd.com/read/28100994/reocclusion-after-self-expandable-metallic-stent-placement-for-relieving-malignant-colorectal-obstruction-as-a-palliative-treatment
#8
Toshikatsu Nitta, Kensuke Fujii, Yoshimasa Hirata, Tomo Tominaga, Yoshihiro Inoue, Hiroshi Kawasaki, Ken Kawakami, Takashi Ishibashi
Self-expandable metallic stent (SEMS) placement has been practiced in several hospitals in Japan, including ours, since January 2012. Here, we report the case of an 82-year-old Japanese man who presented to the hospital with a 1-week history of right hypochondrial pain. Computed tomography (CT) findings indicated colorectal cancer. The laboratory findings on admission indicated severe anemia (red blood cell count, 426 × 104/μL; hemoglobin, 7.9 g/dL). We performed SEMS placement because the patient refused to undergo surgery...
September 2016: Case Reports in Gastroenterology
https://www.readbyqxmd.com/read/28100958/routine-dyspnea-assessment-and-documentation-nurses-experience-yields-wide-acceptance
#9
Kathy M Baker, Susan DeSanto-Madeya, Robert B Banzett
BACKGROUND: Dyspnea (breathing discomfort) is a common and distressing symptom. Routine assessment and documentation can improve management and relieve suffering. A major barrier to routine dyspnea documentation is the concern that it will have a deleterious effect on nursing workflow and that it will not be readily accepted by nurses. Nurses at our institution recently began to assess and document dyspnea on all medical-surgical patients upon admission and once per shift throughout their hospitalization...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28100880/significant-association-of-serum-adiponectin-and-creatine-kinase-mb-levels-in-st-segment-elevation-myocardial-infarction
#10
Tomoaki Natsukawa, Norikazu Maeda, Shiro Fukuda, Masaya Yamaoka, Yuya Fujishima, Hirofumi Nagao, Fumi Sato, Hitoshi Nishizawa, Hirotaka Sawano, Yasuyuki Hayashi, Tohru Funahashi, Tatsuro Kai, Iichiro Shimomura
AIMS: Adiponectin, an adipocyte-specific secretory protein, abundantly exists in the blood stream while its concentration paradoxically decreases in obesity. Hypoadiponectinemia is one of risks of cardiovascular diseases. However, impact of serum adiponectin concentration on acute ischemic myocardial damages has not been fully clarified. The present study investigated the association of serum adiponectin and creatine kinase (CK)-MB levels in subjects with ST-segment elevation myocardial infarction (STEMI)...
January 17, 2017: Journal of Atherosclerosis and Thrombosis
https://www.readbyqxmd.com/read/28100563/effect-of-socioeconomic-disadvantage-remoteness-and-indigenous-status-on-hospital-usage-for-western-australian-preterm-infants-under-12%C3%A2-months-of-age-a-population-based-data-linkage-study
#11
Natalie A Strobel, Sue Peter, Kimberley E McAuley, Daniel R McAullay, Rhonda Marriott, Karen M Edmond
OBJECTIVES: Our primary objective was to determine the incidence of hospital admission and emergency department presentation in Indigenous and non-Indigenous preterm infants aged postdischarge from birth admission to 11 months in Western Australia. Secondary objectives were to assess incidence in the poorest infants from remote areas and to determine the primary causes of hospital usage in preterm infants. DESIGN: Prospective population-based linked data set. SETTING AND PARTICIPANTS: All preterm babies born in Western Australia during 2010 and 2011...
January 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28100561/investigation-of-the-degree-of-organisational-influence-on-patient-experience-scores-in-acute-medical-admission-units-in-all-acute-hospitals-in-england-using-multilevel-hierarchical-regression-modelling
#12
Paul Sullivan, Derek Bell
OBJECTIVES: Previous studies found that hospital and specialty have limited influence on patient experience scores, and patient level factors are more important. This could be due to heterogeneity of experience delivery across subunits within organisations. We aimed to determine whether organisation level factors have greater impact if scores for the same subspecialty microsystem are analysed in each hospital. SETTING: Acute medical admission units in all NHS Acute Trusts in England...
January 18, 2017: BMJ Open
https://www.readbyqxmd.com/read/28100222/gestational-age-and-1-year-hospital-admission-or-mortality-a-nation-wide-population-based-study
#13
Silvia Iacobelli, Evelyne Combier, Adrien Roussot, Jonathan Cottenet, Jean-Bernard Gouyon, Catherine Quantin
BACKGROUND: Describe the 1-year hospitalization and in-hospital mortality rates, in infants born after 31 weeks of gestational age (GA). METHODS: This nation-wide population-based study used the French medico-administrative database to assess the following outcomes in singleton live-born infants (32-43 weeks) without congenital anomalies (year 2011): neonatal hospitalization (day of life 1 - 28), post-neonatal hospitalization (day of life 29 - 365), and 1-year in-hospital mortality rates...
January 18, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28100157/characterization-of-planned-and-unplanned-30-day-readmissions-following-vascular-surgical-procedures
#14
Georges Tahhan, Alik Farber, Nishant K Shah, Brianna M Krafcik, Teviah E Sachs, Jeffrey A Kalish, Matthew R Peacock, Jeffrey J Siracuse
OBJECTIVE: Thirty-day readmission is increasingly used as a quality of care indicator. Patients undergoing vascular surgery have historically been at high risk for readmission. We analyzed hospital readmission details to identify patients at high risk for readmission in order to better understand these readmissions and improve resource utilization in this patient population. METHODS: A retrospective review and analysis of our medical center's admission and discharge data were conducted from October 2012 to March 2015...
January 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28100012/characterization-and-management-of-patients-with-heroin-versus-non-heroin-opioid-overdoses-experience-at-an-academic-medical-center
#15
Kate M Morizio, Regan A Baum, Adam Dugan, Julia E Marin, Abby M Bailey
STUDY OBJECTIVES: To characterize the differences between patients who had heroin and non-heroin opioid overdoses and to determine whether there were any significant differences in their management with regard to the naloxone use. DESIGN: Retrospective cohort study. SETTING: Large, academic medical center. PATIENTS: A total of 923 patients admitted to the medical center who were identified for overdose by heroin or other opiate-related narcotics between January 2010 and September 2015; 480 patients experienced a non-heroin opioid overdose event, and 443 patients experienced a heroin overdose event...
January 18, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/28100003/neonatal-morbidity-after-spontaneous-labor-onset-prior-to-intended-cesarean-delivery-at-term-a-cohort-study
#16
Julie Glavind, Ioanna Milidou, Niels Uldbjerg, Rikke Maimburg, Tine Brink Henriksen
INTRODUCTION: We aimed to investigate if labor onset before planned cesarean delivery (CD) affects the risk of neonatal admission, respiratory distress, or neonatal infectious morbidity. MATERIAL AND METHODS: Our cohort included singleton term pregnant women with intended CD who delivered at Aarhus University Hospital from 1990 to 2012. Two groups of women were identified: Women with intended CD performed prior to labor (non-labor CD) and women with intended CD performed after spontaneous labor onset (labor onset CD); in both groups there was no other maternal or fetal medical indication for an immediate CD or for early term CD scheduling...
January 18, 2017: Acta Obstetricia et Gynecologica Scandinavica
https://www.readbyqxmd.com/read/28099786/labor-intervention-and-outcomes-in-women-who-are-nulliparous-and-obese-comparison-of-nurse-midwife-to-obstetrician-intrapartum-care
#17
Nicole S Carlson, Elizabeth J Corwin, Nancy K Lowe
BACKGROUND: Women who are obese have slower labors than women of normal weight, and show reduced response to interventions designed to speed labor progress like oxytocin augmentation and artificial rupture of membranes. The optimal labor management for these women has not been described. METHODS: This retrospective cohort study compared 2 propensity score-matched groups of women (N = 360) who were healthy, nulliparous, spontaneously laboring, and obese (body mass index ≥ 30 kg/m(2) )...
January 18, 2017: Journal of Midwifery & Women's Health
https://www.readbyqxmd.com/read/28099760/clinical-behavioural-and-social-indicators-for-poor-glycaemic-control-around-the-time-of-transfer-to-adult-care-a-longitudinal-study-of-126-young-people-with-diabetes
#18
P Castensøe-Seidenfaden, A Kryger Jensen, H Smedegaard, E Hommel, G Reventlov Husted, U Pedersen-Bjergaard, G Teilmann
AIMS: To describe and compare changes in glycaemic control in young people with Type 1 diabetes over time between the last 2 years in paediatric care and the first 2 years in adult care and to identify risk factors for poor glycaemic control. METHODS: Our retrospective cohort study followed participants aged 14-22 years from 2 years before to 2 years after transfer from paediatric to adult care. Changes in glycaemic control were calculated using repeated measurements...
January 18, 2017: Diabetic Medicine: a Journal of the British Diabetic Association
https://www.readbyqxmd.com/read/28099744/a-retrospective-cohort-study-of-hemostatic-agent-use-during-hysterectomy-and-risk-of-post-operative-complications
#19
John A Harris, Shitanshu Uppal, Neil Kamdar, Carolyn W Swenson, Darrell Campbell, Daniel M Morgan
OBJECTIVE: To determine if the use of intraoperative hemostatic agents was a risk factor for post-operative adverse events within 30 days of patients undergoing hysterectomy. METHOD: A population-based retrospective cohort study included data from patients undergoing hysterectomy for any indication between January 1, 2013, and December 31, 2014, at 52 hospitals in Michigan, USA. Any individuals with missing covariate data were excluded, and multivariable logistic regression and propensity score-matching were used to estimate the rate of post-operative adverse events associated with intra-operative hemostatic agents independent of demographic and surgical factors...
February 2017: International Journal of Gynaecology and Obstetrics
https://www.readbyqxmd.com/read/28099737/decreased-rates-of-shoulder-dystocia-and-brachial-plexus-injury-via-an-evidence-based-practice-bundle
#20
Laura E Sienas, Herman L Hedriana, Suzanne Wiesner, Barbara Pelletreau, Machelle D Wilson, Laurence E Shields
OBJECTIVE: To evaluate whether a standardized approach to identify pregnant women at risk for shoulder dystocia (SD) is associated with reduced incidence of SD and brachial plexus injury (BPI). METHODS: Between 2011 and 2015, prospective data were collected from 29 community-based hospitals in the USA during implementation of an evidence-based practice bundle, including an admission risk assessment, required "timeout" before operative vaginal delivery (OVD), and low-fidelity SD drills...
February 2017: International Journal of Gynaecology and Obstetrics
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