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https://www.readbyqxmd.com/read/28214235/effects-of-postacute-settings-on-readmission-rates-and-reasons-for%C3%A2-readmission-following-total-knee-arthroplasty
#1
Rodney Laine Welsh, James E Graham, Amol M Karmarkar, Natalie E Leland, Jacques G Baillargeon, Dana L Wild, Kenneth J Ottenbacher
OBJECTIVES: Examine the effects of postacute discharge setting on unplanned hospital readmissions following total knee arthroplasty (TKA) in older adults. DESIGN: Secondary analyses of 100% Medicare (inpatient) claims files. SETTING: Acute hospitals across the United States. PARTICIPANTS: Medicare fee-for-service beneficiaries ≥66 years of age who were discharged from an acute hospital following TKA in 2009-2011 (n = 608,031)...
February 14, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/28213620/post-contrast-acute-kidney-injury-in-intensive-care-unit-patients-a-propensity-score-adjusted-study
#2
Jennifer S McDonald, Robert J McDonald, Eric E Williamson, David F Kallmes, Kianoush Kashani
PURPOSE: To examine the association of intravenous iodinated contrast material administration with the subsequent development of post-contrast AKI (PC-AKI), emergent dialysis, and short-term mortality using a propensity score-adjusted analysis of a cohort of intensive care unit (ICU) patients who underwent CT examination. METHODS: All ICU patients at our institution who received a contrast-enhanced (contrast group) or unenhanced (noncontrast group) CT scan from January 2006 to December 2014 were identified...
February 17, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28209484/successful-provision-of-inter-hospital-extracorporeal-cardiopulmonary-resuscitation-for-acute-post-partum-pulmonary-embolism
#3
C McDonald, J Laurie, S Janssens, C Zazulak, P Kotze, K Shekar
Mortality during pregnancy in a well-resourced setting is rare, but acute pulmonary embolism is one of the leading causes. We present the successful use of extracorporeal cardiopulmonary resuscitation (eCPR) in a 22-year old woman who experienced cardiopulmonary collapse following urgent caesarean section in the setting of a sub-massive pulmonary embolus. Resources and personnel to perform eCPR were not available at the maternity hospital and were recruited from an adjacent pediatric hospital. Initial care used low blood flow extracorporeal membrane oxygenation (ECMO) with pediatric ECMO circuitry, which was optimized when the team from a nearby adult cardiac hospital arrived...
January 9, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28191382/inadvertent-skipping-of-steroids-in-septic-shock-leads-to-a-diagnosis-of-adult-onset-still-s-disease
#4
Vinoth K Sethuraman, Kavitha Balasubramanian, Stalin Viswanathan, Rajeswari Aghoram
Adult onset Still's disease is uncommon in middle-aged and elderly individuals and can rarely present with shock; shock is usually associated with disseminated intravascular coagulation, multiorgan dysfunction syndrome or acute respiratory distress syndrome. We report a post-menopausal woman with arthritis, fever, pneumonitis and hypotension which was managed as septic shock. Steroids were inadvertently missed during the second day of hospitalization in the intensive care unit. Persistence of hypotension on inotropes, with normal renal, hepatic and neurological function and recurrence of fever when steroids were skipped, led to suspicion of an inflammatory disorder...
January 14, 2017: Curēus
https://www.readbyqxmd.com/read/28152729/reducing-hospital-aquired-pneumonia-hap-with-massey-screen
#5
Robyn Dunbar, Cheryl Clements, Margaret Bonawitz, Joanne McGovern
: 232 Background: Hospital Acquired Pneumonia (HAP) is a leading cause of prolonged hospitalization in patients. The oncology population is especially susceptible to critical illness related to an immunocompromised state. The purpose of this study was to implement the Massey Bedside Swallowing Screen upon admission to the oncology telemetry unit to detect any deficits that could potentially lead to HAP, in conjunction with strict oral care for identified high risk patients. METHODS: The importance of the Massey Bedside Swallowing Screen upon admission and the knowledge that early detection leads to better patient outcomes was educated to the nursing staff...
March 2016: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28151493/surfactant-reduced-the-mortality-of-neonates-with-birth-weight-%C3%A2-1500%C3%A2-g-and-hypoxemic-respiratory-failure-a-survey-from-an-emerging-nicu-network
#6
H Wang, X Gao, C Liu, C Yan, X Lin, Y Dong, B Sun
OBJECTIVE: We evaluated the efficacy of surfactant therapy and assisted ventilation on morbidity and mortality of neonates with birth weight (BW) ⩾1500 g and hypoxemic respiratory failure (HRF). STUDY DESIGN: We retrospectively analyzed 5650 patients with BW ⩾1500 g for incidence, management and outcome of HRF, defined as acute hypoxemia requiring mechanical ventilation and/or nasal continuous positive airway pressure ⩾24 h. The patients were allocated into groups of moderate preterm (1735, 30...
February 2, 2017: Journal of Perinatology: Official Journal of the California Perinatal Association
https://www.readbyqxmd.com/read/28150850/chewing-versus-swallowing-ticagrelor-to-accelerate-platelet-inhibitionin-acute-coronary-syndrome-the-cheers-study-for-the-platis-platelets-and-thrombosis-in-sheba-study-group
#7
Elad Asher, Shir Frydman, Moshe Katz, Ehud Regev, Avi Sabbag, Israel Mazin, Arsalan Abu-Much, Andrew Kukuy, Anna Mazo, Aharon Erez, Anat Berkovitch, Michael Narodistky, Israel Barbash, Amit Segev, Roy Beigel, Shlomi Matetzky
It was the study objective to evaluate whether chewing a 180 mg loading dose of ticagrelor versus an equal dose of traditional oral administration, enhances inhibition of platelet aggregation 1 hour (h) after administering a ticagrelor loading dose in non-ST elevation myocardial infarction (NSTEMI) patients. Dual anti-platelet therapy represents standard care for treating NSTEMI patients. Ticagrelor is a direct acting P2Y12 inhibitor and, unlike clopidogrel and prasugrel, does not require metabolic activation...
February 2, 2017: Thrombosis and Haemostasis
https://www.readbyqxmd.com/read/28149825/correlations-between-pulmonary-artery-pressures-and-inferior-vena-cava-collapsibility-in-critically-ill-surgical-patients-an-exploratory-study
#8
Stanislaw P Stawicki, Thomas J Papadimos, David P Bahner, David C Evans, Christian Jones
INTRODUCTION: As pulmonary artery catheter (PAC) use declines, search continues for reliable and readily accessible minimally invasive hemodynamic monitoring alternatives. Although the correlation between inferior vena cava collapsibility index (IVC-CI) and central venous pressures (CVP) has been described previously, little information exists regarding the relationship between IVC-CI and pulmonary artery pressures (PAPs). The goal of this study is to bridge this important knowledge gap...
October 2016: International Journal of Critical Illness and Injury Science
https://www.readbyqxmd.com/read/28142216/how-do-low-birth-weight-neonates-fare-two-years-after-discharge-from-a-low-technology-neonatal-care-unit-in-a-rural-district-hospital-in-burundi
#9
W van den Boogaard, I Zuniga, M Manzi, R Van den Bergh, A Lefevre, K Nanan-N'zeth, B Duchenne, W Etienne, N Juma, B Ndelema, R Zachariah, A Reid
OBJECTIVES: As neonatal care is being scaled up in economically poor settings, there is a need to know more on post-hospital discharge and longer-term outcomes. Of particular interest are mortality, prevalence of developmental impairments and malnutrition, all known to be worse in low-birth-weight neonates (LBW, <2500 grams). Getting a better handle on these parameters might justify and guide support interventions. Two years after hospital discharge, we thus assessed: mortality, developmental impairments, and nutritional status of LBW children...
January 31, 2017: Tropical Medicine & International Health: TM & IH
https://www.readbyqxmd.com/read/28139394/serious-fall-injuries-before-and-after-initiation-of-hemodialysis-among-older-esrd-patients-in-the-united-states-a-retrospective-cohort-study
#10
Laura C Plantinga, Rachel E Patzer, Harold A Franch, C Barrett Bowling
BACKGROUND: Because initiation of dialysis therapy often occurs in the setting of acute illness and may signal worsening health and functional decline, we examined whether rates of serious fall injuries among older hemodialysis patients differ before and after dialysis therapy initiation. STUDY DESIGN: Retrospective cohort study of claims data from the 2 years spanning dialysis therapy initiation among patients initiating dialysis therapy in 2010 to 2012. SETTING & PARTICIPANTS: Claims from 81,653 Medicare end-stage renal disease beneficiaries aged 67 to 100 years...
January 27, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28126381/the-effect-of-a-short-stay-unit-on-hospital-admission-and-length-of-stay-in-acute-heart-failure-reduce-ahf-study
#11
Òscar Miró, Virginia Carbajosa, W Frank Peacock, Pere Llorens, Pablo Herrero, Javier Jacob, Sean P Collins, Cristina Fernández, Antoni Juan Pastor, Francisco Javier Martín-Sánchez
OBJECTIVE: To determine whether the presence of a short-stay unit(SSU) in a hospital influences the percentage of admissions, length of hospital stay(LOS) and outcomes in emergency department(ED) patients with acute heart failure(AHF). METHOD: Retrospective analysis of AHF patients presenting to one of 34 Spanish ED included in EAHFE registry. Baseline and ED data of patients were collected. Patients were classified into two groups in function of being attended at hospitals with or without a SSU...
January 23, 2017: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/28122406/similar-change-in-platelets-and-leucocytes-24%C3%A2-h-after-injury-is-associated-with-septic-shock-a-week-later
#12
Saskia Jol, Falco Hietbrink, Luke P H Leenen, Leo Koenderman, Karlijn J P van Wessem
BACKGROUND: Septic shock is a severe complication in polytrauma patients. Early identification of patients at risk can guide future prevention strategies. Platelets (PLTs) and leucocytes presumably play an important role in the post-injury inflammatory response. The role of early changes in PLT and leucocyte counts was investigated in search for the aetiology of the development of septic complications. METHODS: Polytrauma patients (aged 16-80 years) admitted to the intensive care unit with an expected stay of at least 3 days were included...
January 25, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28118659/video-laryngoscopy-vs-direct-laryngoscopy-on-successful-first-pass-orotracheal-intubation-among-icu-patients-a-randomized-clinical-trial
#13
Jean Baptiste Lascarrou, Julie Boisrame-Helms, Arthur Bailly, Aurelie Le Thuaut, Toufik Kamel, Emmanuelle Mercier, Jean-Damien Ricard, Virginie Lemiale, Gwenhael Colin, Jean Paul Mira, Ferhat Meziani, Jonathan Messika, Pierre Francois Dequin, Thierry Boulain, Elie Azoulay, Benoit Champigneulle, Jean Reignier
Importance: In the intensive care unit (ICU), orotracheal intubation can be associated with increased risk of complications because the patient may be acutely unstable, requiring prompt intervention, often by a practitioner with nonexpert skills. Video laryngoscopy may decrease this risk by improving glottis visualization. Objective: To determine whether video laryngoscopy increases the frequency of successful first-pass orotracheal intubation compared with direct laryngoscopy in ICU patients...
7, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28104426/survival-expenditure-and-disposition-in-patients-following-out-of-hospital-cardiac-arrest-1995-2013
#14
Shaker M Eid, Marwan S Abougergi, Aiham Albaeni, Nisha Chandra-Strobos
AIMS: To investigate trends in survival to hospital discharge, in-hospital expenditures, and post-acute-care disposition following out-of-hospital cardiac arrest (OHCA) in the United States. METHODS: We performed this nationwide serial cross-sectional study using data from the National Inpatient Sample on all patients (age >18years) hospitalized with OHCA between January 1, 1995, and December 31, 2013. Our main outcome measure was survival to hospital discharge...
January 16, 2017: Resuscitation
https://www.readbyqxmd.com/read/28096737/implementation-of-evidence-on-the-nurse-patient-relationship-in-psychiatric-wards-through-a-mixed-method-design-study-protocol
#15
Antonio R Moreno-Poyato, Pilar Delgado-Hito, Raquel Suárez-Pérez, Juan M Leyva-Moral, Rosa Aceña-Domínguez, Regina Carreras-Salvador, Juan F Roldán-Merino, Teresa Lluch-Canut, Pilar Montesó-Curto
BACKGROUND: Psychiatric nurses are aware of the importance of the therapeutic relationship in psychiatric units. Nevertheless, a review of the scientific evidence indicates that theoretical knowledge alone is insufficient to establish an adequate therapeutic alliance. Therefore, strategies are required to promote changes to enhance the establishment of the working relationship. The aims of the study are to generate changes in how nurses establish the therapeutic relationship in acute psychiatric units, based on participative action research and to evaluate the effectiveness of the implementation of evidence through this method...
2017: BMC Nursing
https://www.readbyqxmd.com/read/28096581/role-of-preemptive-tapentadol-in-reduction-of-postoperative-analgesic-requirements-after-laparoscopic-cholecystectomy
#16
Ghanshyam Yadav, Gaurav Jain, Abhishek Samprathi, Annavi Baghel, Dinesh Kumar Singh
BACKGROUND AND AIMS: Poorly managed acute postoperative pain may result in prolonged morbidity. Various pharmacotherapies have targeted this, but research on an ideal preemptive analgesic continues, taking into account drug-related side effects. Considering the better tolerability profile of tapentadol, we assessed its role as a preemptive analgesic in the reduction of postoperative analgesic requirements, after laparoscopic cholecystectomy. MATERIAL AND METHODS: In a prospective-double-blinded fashion, sixty patients posted for above surgery, were randomized to receive tablet tapentadol 75 mg (Group A) or starch tablets (Group B) orally, an hour before induction of general anesthesia...
October 2016: Journal of Anaesthesiology, Clinical Pharmacology
https://www.readbyqxmd.com/read/28093564/postoperative-conversion-disorder-presenting-as-inspiratory-stridor-and-hemiparesis-in-a-pediatric-patient
#17
Erik J Nelson, Jennifer Y Wu
BACKGROUND Postoperative conversion disorder is rare and has been reported. The diagnosis is usually made after all major organic causes have been ruled out. CASE REPORT We describe a case of a 13-year-old female who presented in the post-anesthesia care unit with acute-onset inspiratory stridor and unresponsiveness to verbal or painful stimuli after receiving a general anesthetic for upper endoscopy. Later in the post-anesthesia care unit, she presented with acute-onset right hemiplegia and sensory loss. She was first evaluated for causes of her stridor and unresponsiveness...
January 17, 2017: American Journal of Case Reports
https://www.readbyqxmd.com/read/28075489/cough-augmentation-techniques-for-extubation-or-weaning-critically-ill-patients-from-mechanical-ventilation
#18
REVIEW
Louise Rose, Neill Kj Adhikari, David Leasa, Dean A Fergusson, Douglas McKim
BACKGROUND: There are various reasons why weaning and extubation failure occur, but ineffective cough and secretion retention can play a significant role. Cough augmentation techniques, such as lung volume recruitment or manually- and mechanically-assisted cough, are used to prevent and manage respiratory complications associated with chronic conditions, particularly neuromuscular disease, and may improve short- and long-term outcomes for people with acute respiratory failure. However, the role of cough augmentation to facilitate extubation and prevent post-extubation respiratory failure is unclear...
January 11, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28074985/-characteristics-and-evolution-of-patients-admitted-to-a-public-hospital-intensive-care-unit
#19
Carolina Ruiz, Miguel Ángel Díaz, Juan Marcelo Zapata, Sebastián Bravo, Sergio Panay, Cristina Escobar, Jorge Godoy, Max Andresen, Ricardo Castro
BACKGROUND: The epidemiology of critical patients in Chile could differ from that reported in international studies. AIM: To describe the causes of admission and evolution of patients who were admitted to the ICU (Intensive Care Unit) of a general hospital in Chile in a two-year period (2012-2013). PATIENTS AND METHODS: A retrospective study was carried out using the ICU database. The following variables were registered: admission diagnosis, APACHE II (Acute Physiology and Chronic Health Evaluation), days of mechanical ventilation (MV), ICU length of stay and ICU and hospital survival...
October 2016: Revista Médica de Chile
https://www.readbyqxmd.com/read/28066607/risk-factors-and-outcome-of-primary-graft-dysfunction-after-lung-transplantation-in-korea
#20
Sungwoo Moon, Moo Suk Park, Jin Gu Lee, Ji Ye Jung, Young Ae Kang, Young Sam Kim, Se Kyu Kim, Joon Chang, Hyo Chae Paik, Song Yee Kim
BACKGROUND: Primary graft dysfunction (PGD) is a severe, acute and post-transplantation lung injury associated with early morbidity and mortality. We aimed to identify clinical risk factors for PGD, as well as the outcome of PGD after lung transplantation in Korea. METHODS: We retrospectively analyzed lung transplant patients in a South Korean Hospital. The primary outcome was grade 3 PGD, defined according to the International Society for Heart and Lung Transplantation criteria...
November 2016: Journal of Thoracic Disease
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