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https://www.readbyqxmd.com/read/29909602/traumatic-stress-among-school-aged-pediatric-surgery-patients-and-their-parents
#1
Amichai Ben Ari, Daniella Margalit, Raphael Udassin, Fortu Benarroch
INTRODUCTION:  Since hospitalization can be a traumatic event for children, many of them may suffer from a cluster of chronic psychological and emotional difficulties called Pediatric Medical Traumatic Stress (PMTS). Although PMTS causes considerable functional impairment and psychological distress and may decrease the children's compliance with post-surgical care, awareness of this condition is low and thus not enough effort is made to prevent it. The objective of this study is to assess prospectively the prevalence and characteristics of PMTS in school-age children following hospitalization in a general pediatric surgery ward and in their parents, which has not been documented before...
June 17, 2018: European Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/29909394/dengue-fever-with-encephalitis-a-rare-phenomenon
#2
Gaurav Baheti, Varshil Mehta, Menka Ramchandani, Gopal Chandra Ghosh
The clinical profile and presentation of patients with dengue fever may differ from asymptomatic infection to the dreadful complications like dengue shock syndrome. However, neurological complications are very rare. Dengue encephalitis occurs by a direct involvement of central nervous system by the dengue virus which is an extremely rare complication. A 33-year-old man presented with fever, vomiting and severe headache. He had one episode of generalised tonic-clonic seizure followed by an altered sensorium on the day of admission to the hospital...
June 15, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29909373/what-insights-do-patients-and-caregivers-have-on-acute-kidney-injury-and-posthospitalisation-care-a-single-centre-qualitative-study-from-toronto-canada
#3
Samuel A Silver, Marianne Saragosa, Neill K Adhikari, Chaim M Bell, Ziv Harel, Andrea Harvey, Abhijat Kitchlu, Javier A Neyra, Ron Wald, Lianne Jeffs
OBJECTIVES: Hospitalisation with acute kidney injury (AKI) is associated with short-term and long-term adverse events, but patient and caregiver experiences with AKI are not well described. We sought to better understand patient and caregiver perspectives after a hospitalisation with AKI to inform discharge strategies that may improve outcomes for this high-risk population. DESIGN: Qualitative study with semistructured interviews. SETTING: Tertiary care hospital in Toronto, Ontario, Canada...
June 15, 2018: BMJ Open
https://www.readbyqxmd.com/read/29909187/epilepsia-partialis-continua-correlation-of-semiology-outcome-and-electrophysiologic-features
#4
Murat Mert Atmaca, Nerses Bebek, Elif Kocasoy-Orhan, Candan Gürses
OBJECTIVE: Epilepsia partialis continua (EPC) is a special form of cortical epilepsy. Several studies have described the ictal and interictal electroencephalography (EEG) findings in patients with EPC; however, lateralizing and localizing values of these findings have been evaluated rarely. This study investigated the correlation of semiologic and EEG findings, and outcomes in patients with EPC. PATIENTS AND METHODS: Clinical and EEG findings and outcomes, and their correlations were studied prospectively in 15 patients who were diagnosed as having EPC upon presentation to Istanbul Medical Faculty Hospital between January 2010 and April 2014, and retrospectively in 5 previously evaluated patients...
June 9, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29909184/rates-causes-risk-factors-and-outcomes-of-readmission-following-deep-brain-stimulation-for-movement-disorders-analysis-of-the-u-s-nationwide-readmissions-database
#5
Kavelin Rumalla, Kyle A Smith, Kenneth A Follett, Jules M Nazzaro, Paul M Arnold
OBJECTIVE: Deep brain stimulation (DBS) surgery has proven benefit for several movement disorders and medically-refractory psychiatric conditions and is considered a fairly safe procedure. We sought to determine the national rates, causes, predictors, and outcomes associated with 30-day and 90-day readmission. PATIENTS AND METHODS: The Nationwide Readmissions Database was queried (January-September 2013) using ICD-9-CM codes, identifying patients who underwent DBS for movement disorder (Parkinson's disease [PD], essential tremor [ET], or dystonia)...
June 10, 2018: Clinical Neurology and Neurosurgery
https://www.readbyqxmd.com/read/29909113/coronary-computed-tomography-angiography-versus-stress-echocardiography-in-acute-chest-pain-a-randomized-controlled-trial
#6
Jeffrey M Levsky, Linda B Haramati, Daniel M Spevack, Mark A Menegus, Terence Chen, Sarah Mizrachi, Durline Brown-Manhertz, Samantha Selesny, Rikah Lerer, Deborah J White, Jonathan N Tobin, Cynthia C Taub, Mario J Garcia
OBJECTIVES: This study sought to compare early emergency department (ED) use of coronary computed tomography angiography (CTA) and stress echocardiography (SE) head-to-head. BACKGROUND: Coronary CTA has been promoted as the early ED chest pain triage imaging method of choice, whereas SE is often overlooked in this setting and involves no ionizing radiation. METHODS: The authors randomized 400 consecutive low- to intermediate-risk ED acute chest pain patients without known coronary artery disease and a negative initial serum troponin level to immediate coronary CTA (n = 201) or SE (n = 199)...
June 8, 2018: JACC. Cardiovascular Imaging
https://www.readbyqxmd.com/read/29909051/early-prophylactic-antibiotics-for-severe-acute-pancreatitis-a-population-based-cohort-study-using-a-nationwide-database-in-japan
#7
Kazuhiko Nakaharai, Kojiro Morita, Taisuke Jo, Hiroki Matsui, Kiyohide Fushimi, Hideo Yasunaga
OBJECTIVES: Previous studies evaluating the clinical benefits of prophylactic antibiotics for severe acute pancreatitis (SAP) have generated inconsistent results due to heterogeneities among the study settings. We determined if early prophylactic antibiotics improved the outcomes of SAP patients using a study designed to overcome these previous methodological weaknesses. METHODS: We conducted a retrospective cohort study of SAP patients discharged between July 2010 and March 2016, using a Japanese nationwide inpatient database...
June 13, 2018: Journal of Infection and Chemotherapy: Official Journal of the Japan Society of Chemotherapy
https://www.readbyqxmd.com/read/29909025/a-comparative-study-of-social-capital-and-hospital-readmission-in-older-adults
#8
Sheryl A Emmerling, Kim Schafer Astroth, Myoung Jin Kim, Wendy M Woith, Mary J Dyck
Numerous factors contribute to hospital readmissions of older adults. The role social capital may play in preventing hospital readmissions is unknown. The aim of this descriptive, cross-sectional study was to determine if levels of personal social capital differ in two groups of patients aged 65 and older, those readmitted to the hospital within 30 days of discharge and those not readmitted. Participants in this study (N = 106) were community-dwelling older adults discharged from 11 hospitals in the Midwestern United States...
June 13, 2018: Geriatric Nursing
https://www.readbyqxmd.com/read/29908956/complement-activation-in-acute-myocardial-infarction-an-early-marker-of-inflammation-and-tissue-injury
#9
Lorena Bavia, Kárita Cláudia Freitas Lidani, Fabiana Antunes Andrade, Miguel Ibraim Abboud Hanna Sobrinho, Renato Mitsunori Nisihara, Iara Jose de Messias-Reason
BACKGROUND: Acute myocardial infarction (AMI) is a potentially fatal condition, being a major cause of death worldwide. Ischemia suffered during AMI causes tissue damage, leading to an inflammatory process. Moreover, myocardial injury can generate damage-associated molecular patterns that activate pattern recognition molecules including some complement proteins. METHODS: Here we investigated products of complement activation, C3d and soluble C5b9 (sC5b9), as potential biomarkers for myocardial injury and inflammation, as well as serum cytokines (IL-6 and TNF-alpha), alpha-1-acid glycoprotein (AGP), and classical markers of myocardial necrosis (creatine kinase, creatine kinase-MB isoform, myoglobin and troponin-I) in a longitudinal study of patients with AMI (from admission, 6 h and 12 h post admission, and at discharge from hospital)...
June 14, 2018: Immunology Letters
https://www.readbyqxmd.com/read/29908155/pharmacokinetics-of-continuous-infusion-beta-lactams-in-the-treatment-of-acute-pulmonary-exacerbations-in-adult-cystic-fibrosis-patients
#10
Lisa T Hong, Theodore G Liou, Rishi Deka, Jordan B King, Vanessa Stevens, David C Young
BACKGROUND: Several clinical trials have demonstrated the efficacy of continuous infusion (CI) beta-lactam (BL) antibiotics in cystic fibrosis (CF) patients; however, little is known regarding pharmacokinetic changes during treatment of an acute pulmonary exacerbation (APE). Identifying and understanding these changes may assist in optimizing antibiotic dosing during APE treatment. METHODS: This study is a retrospective cohort study of 162 adult CF patients admitted to the University of Utah Hospital between January 1, 2008 and May 15, 2014 for treatment of an APE with both a CI BL and intravenous tobramycin...
June 13, 2018: Chest
https://www.readbyqxmd.com/read/29908152/reducing-readmissions-in-patients-with-both-heart-failure-and-chronic-obstructive-pulmonary-disease
#11
REVIEW
Ravi Kalhan, R Kannan Mutharasan
Patients with both chronic obstructive pulmonary disease (COPD) and heart failure (HF) pose particularly high costs to the healthcare system. These diseases arise from similar root causes, have overlapping symptoms, and share similar clinical courses. Because of these strong parallels, strategies to reduce readmissions in patients with both conditions share synergies. Here we present 10 practical tips to reduce readmissions in this challenging population. 1: Diagnose the population accurately. 2: Detect admissions for exacerbations early and consider risk-stratification...
June 13, 2018: Chest
https://www.readbyqxmd.com/read/29907737/paradoxical-reaction-in-a-patient-with-co-occurring-tuberculous-meningitis-and-pott-s-disease
#12
Talia Robledo-Gil, Kaoru Harada, Ichiro Ikuta, Merceditas Villanueva
BACKGROUND Paradoxical reactions to tuberculosis (TB) are clinical or radiological worsening of prior tuberculous lesions or the development of new lesions upon treatment with appropriate anti-tuberculosis therapy (ATT). This phenomenon has been described in both HIV-seropositive and HIV-seronegative patients. Although historically estimated to occur in 6-30% of HIV-seronegative patients with TB, the phenomenon is often under-recognized in the current era, particularly in countries of low TB prevalence. We describe a case of a TB paradoxical reaction affecting the CNS and spine in an HIV-seronegative individual who received clinical care in the U...
June 16, 2018: American Journal of Case Reports
https://www.readbyqxmd.com/read/29907656/temporal-trends-in-the-outcomes-of-dialysis-patients-admitted-with-acute-ischemic-stroke
#13
Fahad Alqahtani, Chalak O Berzingi, Sami Aljohani, Mohamed Al Hajji, Anas Diab, Muhammad Alvi, Khaled Boobes, Mohamad Alkhouli
BACKGROUND: There is a paucity of contemporary data on the characteristics and outcomes of acute ischemic stroke (AIS) in patients on maintenance dialysis. METHODS AND RESULTS: We used the nationwide inpatient sample to examine contemporary trends in the incidence, management patterns, and outcomes of AIS in dialysis patients. A total of 930 010 patients were admitted with AIS between 2003 and 2014, of whom 13 642 (1.5%) were on dialysis. Overall, the incidence of AIS among dialysis patients decreased significantly ( P trend <0...
June 15, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29907635/increasing-rate-of-pulmonary-embolism-diagnosed-in-hospitalized-children-in-the-united-states-from-2001-to-2014
#14
Shannon L Carpenter, Troy Richardson, Matt Hall
Although rare in children, pulmonary embolism (PE) can cause significant morbidity and mortality. Overall rates of venous thromboembolism (VTE) are increasing in hospitalized children. By using the Pediatric Health Information System database, we evaluated incidence, treatment, and outcome of PE in children younger than age 18 years from 2001 to 2014. Demographic characteristics for those admitted with VTE alone and those admitted with PE were compared. Rates of PE by year were compared with the number of hospital and VTE admissions...
June 26, 2018: Blood Advances
https://www.readbyqxmd.com/read/29907406/first-spot-urine-sodium-after-initial-diuretic-identifies-patients-at-high-risk-for-adverse-outcome-after-heart-failure-hospitalization
#15
Adriana Luk, John D Groarke, Akshay S Desai, Syed Saad Mahmood, Deepa M Gopal, Emer Joyce, Sachin P Shah, Joann Lindenfeld, Lynne Stevenson, Neal K Lakdawala
BACKGROUND: Relief of congestion is the primary goal of initial therapy for acute decompensated heart failure (ADHF). Early measurement of urine sodium concentration (UNa) may be useful to identify patients with diminished response to diuretics. The aim of this study was to determine if the first spot UNa after diuretic initiation could select patients likely to require more intensive therapy during hospitalization. METHODS: At the time of admission, 103 patients with ADHF were identified prospectively, and UNa was measured after the first dose of intravenous diuretic...
May 19, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29907379/prediction-of-prognosis-in-chronic-obstructive-pulmonary-disease-patients-with-respiratory-failure-a-comparison-of-three-nutritional-assessment-methods
#16
Ruiqi Chen, Lu Xing, Chao You, Xuemei Ou
OBJECTIVES: Due to their increased energy expenditure, chronic obstructive pulmonary disease (COPD) patients with respiratory failure are susceptible to malnutrition. This study aimed to compare the predictive values of the following three widely used nutritional assessment methods for the clinical prognosis of COPD patients with respiratory failure: body mass index (BMI), Nutritional Risk Screening 2002 (NRS 2002), and serum albumin (ALB) level. METHODS: COPD patients with respiratory failure treated in our center from June 2013 to June 2016 were retrospectively included...
June 12, 2018: European Journal of Internal Medicine
https://www.readbyqxmd.com/read/29907362/emergency-department-arrival-times-in-florida-heart-failure-patients-utilizing-fisher-rao-curve-registration-a-descriptive-population-based-study
#17
Glenna Schluck, Wei Wu, James Whyte, Laurie Abbott
BACKGROUND: Emergency room utilization and hospital readmission rates are disproportionately high for heart failure patients (HF). Emergency department (ED) utilization is intimately intertwined with hospital readmissions. OBJECTIVE: Describe the arrival time distribution of HF patients presenting to the ED. METHOD: The study analyzed heart failure discharge data from the Florida State Emergency Department Database and the Florida State Inpatient Database from the Healthcare Cost and Utilization Project of the Agency for Healthcare Research and Quality...
June 12, 2018: Heart & Lung: the Journal of Critical Care
https://www.readbyqxmd.com/read/29907229/effects-of-medicaid-expansion-on-disparities-in-trauma-care-and-outcomes-in-young-adults
#18
Manzilat Akande, Peter C Minneci, Katherine J Deans, Henry Xiang, Deena J Chisolm, Jennifer N Cooper
BACKGROUND: Racial/ethnic and socioeconomic disparities in trauma care and outcomes among young adults are well documented. As the Patient Protection and Affordable Care Act Medicaid expansion has increased insurance coverage among young adults, we aimed to investigate its impact on disparities in insurance coverage and outcomes among hospitalized young adult trauma patients. MATERIALS AND METHODS: We used the healthcare cost and utilization project state inpatient databases to examine changes in insurance coverage and risk-adjusted outcomes from before (2012-2013) to after (2014) Medicaid expansion among young adults (age 19-44) hospitalized for injury across 11 Medicaid expansion states...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29907208/well-differentiated-thyroid-cancer-and-robotic-transaxillary-surgery-at-a-north-american-institution
#19
Meghan Garstka, Khuzema Mohsin, Daniah Bu Ali, Hosam Shalaby, Kareem Ibraheem, Mahmoud Farag, Sang-Wook Kang, Emad Kandil
BACKGROUND: Recent studies from Asia have reported the safety and feasibility of robotic-assisted thyroid surgery. In the United States, several small series and case reports have been published, mostly regarding treatment of benign disease. The aim of our study is to report the safety and feasibility of robotic surgery for well-differentiated thyroid cancer patients at a North American institution. MATERIALS AND METHODS: We performed a retrospective cohort study using a prospectively collected single-center clinical database at Tulane University Medical Center...
August 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29907207/utilization-and-effectiveness-of-multimodal-discharge-analgesia-for-postoperative-pain-management
#20
Karishma Desai, Ian Carroll, Steven M Asch, Tina Seto, Kathryn M McDonald, Catherine Curtin, Tina Hernandez-Boussard
BACKGROUND: Although evidence-based guidelines recommend a multimodal approach to pain management, limited information exists on adherence to these guidelines and its association with outcomes in a generalized population. We sought to assess the association between discharge multimodal analgesia and postoperative pain outcomes in two diverse health care settings. METHODS: We evaluated patients undergoing four common surgeries associated with high pain in electronic health records from an academic hospital (AH) and Veterans Health Administration (VHA)...
August 2018: Journal of Surgical Research
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