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https://www.readbyqxmd.com/read/28822828/targeted-lowering-of-central-blood-pressure-in-patients-with-hypertension-baseline-recruitment-rationale-and-design-of-a-randomized-controlled-trial-the-low-cbp-study
#1
James E Sharman, Tony Stanton, Christopher M Reid, Anthony Keech, Philip Roberts-Thomson, Simon Stewart, Robert Greenough, Michael Stowasser, Walter P Abhayaratna
BACKGROUND: High blood pressure (BP) is the most common modifiable cause of death from cardiovascular disease. Lowering BP with medication improves patient outcomes, but even in populations with normal upper arm (brachial) BP there remains considerable residual risk for cardiovascular disease and this may be due to persistently elevated central BP. There has never been a trial to determine the value of targeted central BP lowering among patients with hypertension, and this was the aim of this study...
August 16, 2017: Contemporary Clinical Trials
https://www.readbyqxmd.com/read/28822781/inpatient-versus-outpatient-parenteral-antibiotic-therapy-at-home-for-acute-infections-in-children-a-systematic-review
#2
REVIEW
Penelope A Bryant, Naomi T Katz
Inpatient management is necessary in many situations, but medical and allied-health treatments are increasingly being used on an outpatient basis to allow patients who would traditionally have been admitted to hospital to remain at home. Home-based clinical management has many potential benefits, including reduced hospital-acquired infections, cost savings, and patient and family satisfaction. Studies in adults provide evidence for the benefits of home-based versus hospital-based intravenous antibiotics, but few studies inform practice in home-based intravenous antibiotic therapy for children...
August 16, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/28822449/-cytokine-profiles-of-cd4-t-memory-cells-in-asthma-and-their-relationship-with-asthma-severity
#3
C L Du, K Xu, Z H Min, D D Li, H L Yuan, C Liu, Z H Chen
Objective: To study the phenotype of memory CD4(+) T cells in peripheral blood of asthmatics and its relationship with asthma severity. Methods: From Dec 2014 to Aug 2015, thirty-three asthmatics, twenty-six chronic obstructive pulmonary disease (COPD) patients and twenty-two healthy volunteers were enrolled in Respiratory Clinics of Zhongshan Hospital, Fudan University. Peripheral blood mononuclear cells (PBMCs) were isolated from peripheral blood. Cell surface markers (CD45RO, CRTH2, CD62L, and CCR7) and intracellular protein[interleukin (IL)-5, IL-17, interferon (IFN)-γ]staining was performed using flow-cytometric techniques...
August 8, 2017: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/28821988/presentation-and-management-of-symptomatic-central-bone-cement-embolization
#4
Ahmed Samir Barakat, Tamer Owais, Mohamed Alhashash, Mootaz Shousha, Hesham El Saghir, Bernward Lauer, Heinrich Boehm
BACKGROUND CONTEXT: With more cement augmentation procedures done, the occurrence of serious complications is also expected to rise. Symptomatic central cement embolization is a rare but very serious complication. Moreover, the pathophysiology and treatment of intrathoracic cement embolism remain controversial. PURPOSE: In this case series, we are trying to identify various presentations and suggest our emergent management scheme for symptomatic central cement embolization...
August 18, 2017: European Spine Journal
https://www.readbyqxmd.com/read/28821408/is-late-life-dependency-increasing-or-not-a-comparison-of-the-cognitive-function-and-ageing-studies-cfas
#5
Andrew Kingston, Pia Wohland, Raphael Wittenberg, Louise Robinson, Carol Brayne, Fiona E Matthews, Carol Jagger
BACKGROUND: Little is known about how the proportions of dependency states have changed between generational cohorts of older people. We aimed to estimate years lived in different dependency states at age 65 years in 1991 and 2011, and new projections of future demand for care. METHODS: In this population-based study, we compared two Cognitive Function and Ageing Studies (CFAS I and CFAS II) of older people (aged ≥65 years) who were permanently registered with a general practice in three defined geographical areas (Cambridgeshire, Newcastle, and Nottingham; UK)...
August 14, 2017: Lancet
https://www.readbyqxmd.com/read/28819984/adherence-to-diurnal-cortisol-sampling-among-mother-child-dyads-from-maltreating-and-nonmaltreating-families
#6
Kristin Valentino, Ashley De Alba, Leah C Hibel, Kaitlin Fondren, Christina G McDonnell
There has been increasing interest in evaluating whether interventions for child maltreatment can improve and/or prevent child physiological dysregulation via measurement of diurnal cortisol. The assessment of diurnal cortisol typically involves the home-based collection of saliva multiple times per day, bringing forth important methodological considerations regarding adherence to collection instructions. To date, there has been no data regarding adherence to home collection of diurnal cortisol among maltreating families...
January 1, 2017: Child Maltreatment
https://www.readbyqxmd.com/read/28818884/contributions-of-a-hand-held-fan-to-self-management-of-chronic-breathlessness
#7
Tim Luckett, Jane Phillips, Miriam J Johnson, Morag Farquhar, Flavia Swan, Teresa Assen, Priyanka Bhattarai, Sara Booth
This study explored the benefits of a hand-held fan as perceived by patients with chronic breathlessness and their carers.A secondary multimethod analysis was conducted of interview data collected in three clinical trials. Two researchers independently coded level of benefit qualitatively reported by each patient. Univariate and multivariate statistics were used to explore perceived benefit as a factor of sex, age and diagnosis. Qualitative analysis used an integrative method.133 patients commented on the fan, of whom 72 had a carer...
August 2017: European Respiratory Journal: Official Journal of the European Society for Clinical Respiratory Physiology
https://www.readbyqxmd.com/read/28817857/patient-centered-home-model-of-care-and-the-role-of-patient-care-teams-in-the-treatment-and-management-of-chronic-disease
#8
Maryam Rahim Sheikh, Muhammad Shahjahan Khan, Jean M Lageson
Patient-centered medical home (PCMH) is a concept of a team of providers caring for a panel of patients with the goals to improve the quality of care while simultaneously decreasing the cost of that care. The clinical evidence that the PCMH approach achieves either goal is mixed. More studies are in progress that will provide more data.
2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28817337/oral-health-integration-into-a-pediatric-practice-and-coordination-of-referrals-to-a-colocated-dental-home-at-a-federally-qualified-health-center
#9
Nandini Sengupta, Sonal Nanavati, Maria Cericola, Lisa Simon
We have integrated preventive oral health measures into preventive care visits for children at a federally qualified health center in Boston, Massachusetts. The program, started in 2015, covers 3400 children and has increased universal caries risk screening in primary care to 85%, fluoride varnish application rates to 80%, and referrals to a dental home to 35%. We accomplished this by minimizing pressures on providers' workflow, empowering medical assistants to lead the initiative, and utilizing data-driven improvement strategies, alongside colocated coordinated care...
August 17, 2017: American Journal of Public Health
https://www.readbyqxmd.com/read/28816338/prediction-of-emergency-department-hospital-admission-based-on-natural-language-processing-and-neural-networks
#10
Xingyu Zhang, Joyce Kim, Rachel E Patzer, Stephen R Pitts, Aaron Patzer, Justin D Schrager
OBJECTIVE: To describe and compare logistic regression and neural network modeling strategies to predict hospital admission or transfer following initial presentation to Emergency Department (ED) triage with and without the addition of natural language processing elements. METHODS: Using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS), a cross-sectional probability sample of United States EDs from 2012 and 2013 survey years, we developed several predictive models with the outcome being admission to the hospital or transfer vs...
August 16, 2017: Methods of Information in Medicine
https://www.readbyqxmd.com/read/28814134/demonstrating-the-relationship-between-school-nurse-workload-and-student-outcomes
#11
Donna Daughtry, Martha Keehner Engelke
This article describes how one very large, diverse school district developed a Student Acuity Tool for School Nurse Assignment and used a logic model to successfully advocate for additional school nurse positions. The logic model included three student outcomes that were evaluated: provide medications and procedures safely and accurately, increase the number of students with a medical home, and increase the number of students with chronic illness that receive case management. Pairing a staffing formula with an evaluation plan that focuses on student outcomes and the priorities of the school district provides a strong case that school nurses are essential and that they contribute to student success...
January 1, 2017: Journal of School Nursing: the Official Publication of the National Association of School Nurses
https://www.readbyqxmd.com/read/28813774/pulmonary-embolism-caused-by-popliteal-vein-aneurysm-a-case-report
#12
Kevin Marquez, Kalyan Chakravarthy Potu, Chad Laurich, Randall Lamfers
In this case report, we describe an unusual episode of bilateral submassive pulmonary embolism (PE) caused by a popliteal vein aneurysm (PVA). The development of PE stems from many risk factors including obesity (BMI³ 30 kg/m2), hypertension, cigarette smoking (greater than 25 cigarettes per day), increasing age, surgery, immobility, malignancy, and inherited thrombophilia. A PVA is a rare but significant cause of PE. A 28-year-old male presented to the emergency department with progressive shortness of breath...
March 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28813473/the-availability-of-pharmacies-in-the-united-states-2007-2015
#13
Dima Mazen Qato, Shannon Zenk, Jocelyn Wilder, Rachel Harrington, Darrell Gaskin, G Caleb Alexander
IMPORTANCE: Despite their increasingly important role in health care delivery, little is known about the availability, and characteristics, of community pharmacies in the United States. OBJECTIVES: (1) To examine trends in the availability of community pharmacies and pharmacy characteristics (24-hour, drive-up, home delivery, e-prescribing, and multilingual staffing) associated with access to prescription medications in the U.S. between 2007 and 2015; and (2) to determine whether and how these patterns varied by pharmacy type (retail chains, independents, mass retailers, food stores, government and clinic-based) and across counties...
2017: PloS One
https://www.readbyqxmd.com/read/28812472/modifiable-risk-factors-associated-with-bronchiolitis
#14
Raffaella Nenna, Renato Cutrera, Antonella Frassanito, Claudia Alessandroni, Ambra Nicolai, Giulia Cangiano, Laura Petrarca, Serena Arima, Serena Caggiano, Nicola Ullman, Paola Papoff, Enea Bonci, Corrado Moretti, Fabio Midulla
BACKGROUND: We sought to clarify possibly modifiable risk factors related to pollution responsible for acute bronchiolitis in hospitalized infants. METHODS: For this observational study, we recruited 213 consecutive infants with bronchiolitis (cases: median age: 2 months; age range: 0.5-12 months; boys: 55.4%) and 213 children aged <3 years (controls: median age: 12 months; age range: 0.5-36 months; boys: 54.5%) with a negative medical history for lower respiratory tract diseases hospitalized at 'Sapienza' University Rome and IRCCS Bambino Gesù Hospital...
August 1, 2017: Therapeutic Advances in Respiratory Disease
https://www.readbyqxmd.com/read/28812381/retrospective-review-of-sglt2-inhibitor-exposures-reported-to-13-poison-centers
#15
Scott E Schaeffer, Carol DesLauriers, Henry A Spiller, Alfred Aleguas, Salvador Baeza, Mark L Ryan
BACKGROUND: SGLT2 inhibitors are a new class of oral antidiabetics prescribed in the United States since 2013. They act by inhibiting reabsorption of glucose in the proximal convoluted tubule of the kidney, allowing excess glucose to be excreted. Little has been reported regarding effects of non-therapeutic exposure to this class of medication. METHODS: Retrospective records from 13 poison centers were examined for human exposures to SGLT2 inhibitors between 1st January 2013 and 31st December 2016...
August 16, 2017: Clinical Toxicology
https://www.readbyqxmd.com/read/28811014/assessing-need-for-pharmacist-involvement-to-improve-care-coordination-for-patients-on-lai-antipsychotics-transitioning-from-hospital-to-home-a-work-system-approach
#16
Olufunmilola Abraham, Michelle N Myers, Amanda L Brothers, Jamie Montgomery, Bryan A Norman, Tanya Fabian
BACKGROUND: The use of Long-Acting Injectable (LAI) antipsychotic medications has increased for patients with Serious Mental Illness (SMI). Care coordination for this population is complex, and pharmacist involvement may improve and support long-term medication adherence and patient outcomes. OBJECTIVES: (1) Examine pharmacists' role in addressing care coordination and adherence challenges for patients taking Long-Acting Injectable (LAI) antipsychotics; and (2) explore patients' medication use experiences with LAI antipsychotics and educational needs...
September 2017: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/28810943/language-barrier-as-a-risk-factor-for-injuries-from-patient-violence-among-direct-care-workers-in-home-settings-findings-from-a-u-s-national-sample
#17
Ha Do Byon, Shijun Zhu, George Unick, Carla Storr, Jane Lipscomb
This study explored potential risk factors for injuries from patient violence among direct care workers in U.S. homes (DCWHs). A national probability sample of 3,377 DCWHs including home health and personal care aides was analyzed using complex sample analysis and generalized estimating equation. Injury from violence was defined as a workrelated injury sustained by aggression, violence, or abuse that was reported to the agency, required medical attention or resulted in absenteeism from work. An association between suffering an injury from patient violence and having a language barrier with patients was noted (OR = 4...
August 15, 2017: Violence and Victims
https://www.readbyqxmd.com/read/28809725/clinical-characteristics-and-complications-of-pediatric-liver-biopsy-a-single-centre-experience
#18
Patricia Almeida, Richard A Schreiber, Jennifer Liang, Quais Mujawar, Orlee R Guttman
INTRODUCTION: Percutaneous liver biopsy (LB) is the gold standard method for evaluation and management of patients with liver disease. The purpose of this study was to characterize pediatric patients undergoing LB at British Columbia Children's Hospital, and to determine the rate and timing of complications following the procedure. MATERIAL AND METHODS: The medical records of all pediatric patients who underwent LB during a six-year retrospective study were reviewed to collect demographic and procedure-related data...
August 8, 2017: Annals of Hepatology
https://www.readbyqxmd.com/read/28808852/patient-experience-with-the-patient-centered-medical-home-in-michigan-s-statewide-multi-payer-demonstration-a-cross-sectional-study
#19
Issidoros Sarinopoulos, Diane L Bechel-Marriott, Jean M Malouin, Shaohui Zhai, Jason C Forney, Clare L Tanner
BACKGROUND: The literature on patient-centered medical homes (PCMHs) and patient experience is somewhat mixed. Government and private payers are promoting multi-payer PCMH initiatives to align requirements and resources and to enhance practice transformation outcomes. To this end, the multipayer Michigan Primary Care Transformation (MiPCT) demonstration project was carried out. OBJECTIVE: To examine whether the PCMH is associated with a better patient experience, and whether a mature, multi-payer PCMH demonstration is associated with even further improvement in the patient experience...
August 14, 2017: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/28807457/identification-of-pseudobulbar-affect-symptoms-in-the-nursing-home-setting-development-and-assessment-of-a-screening-tool
#20
Carrie Allen, Barbara Zarowitz, Terrence O'Shea, Edward Peterson, Charles Yonan, Fanta Waterman
Pseudobulbar Affect (PBA) is a neurologic condition characterized by involuntary outbursts of crying and/or laughing disproportionate to patient mood or social context. Although an estimated 9% of nursing home residents have symptoms suggestive of PBA, they are not routinely screened. Our goal was to develop an electronic screening tool based upon characteristics common to nursing home residents with PBA identified through medical record data. Nursing home residents with PBA treated with dextromethorphan hydrobromide/quinidine sulfate (n = 140) were compared to age-, gender-, and dementia-diagnosis-matched controls without PBA or treatment (n = 140)...
August 11, 2017: Geriatric Nursing
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