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https://www.readbyqxmd.com/read/27915457/combined-use-of-the-rationalization-of-home-medication-by-an-adjusted-stopp-in-older-patients-rasp-list-and-a-pharmacist-led-medication-review-in-very-old-inpatients-impact-on-quality-of-prescribing-and-clinical-outcome
#1
Lorenz Van der Linden, Liesbeth Decoutere, Karolien Walgraeve, Koen Milisen, Johan Flamaing, Isabel Spriet, Jos Tournoy
BACKGROUND: Polypharmacy and potentially inappropriate drugs have been associated with negative outcomes in older adults which might be reduced by pharmacist interventions. OBJECTIVES: Our objective was to evaluate the effect of a pharmacist intervention, consisting of the application of the Rationalization of home medication by an Adjusted STOPP in older Patients (RASP) list and a pharmacist-led medication review on polypharmacy, the quality of prescribing, and clinical outcome in geriatric inpatients...
December 3, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27915317/initiating-retinopathy-of-prematurity-screening-before-discharge-from-the-neonatal-care-unit-effect-on-enrolment-in-rural-india
#2
Anand Vinekar, Chaitra Jayadev, Shwetha Mangalesh, Mathew Kurian, Mangat Dogra, Noel Bauer, Bhujang Shetty
OBJECTIVE: To compare the benefits of initiating Retinopathy of Prematurity (ROP) screening at first contact with the admitted infant prior to hospital discharge ('early screening') with screening performed between 21 and 28 days after birth ('conventional screening') in rural India. DESIGN: Prospective study. SETTING: Two Level II neonatal intensive care units (NICU), from two district headquarters in Karnataka state. PARTICIPANTS: Participants: 329 infants admitted in the two NICUs...
November 7, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27915316/lack-of-screening-underlies-most-stage-5-retinopathy-of-prematurity-among-cases-presenting-to-a-tertiary-eye-center-in-india
#3
Rajvardhan Azad, Parijat Chandra, Anil Gangwe, Vivek Kumar
OBJECTIVE: To study the barriers to effective screening, early detection and treatment of Retinopathy of Prematurity leading to advanced disease. DESIGN: Cross-sectional study. SETTING: Tertiary eye care hospital in northern India. PARTICIPANTS: 115 babies with bilateral stage 5 ROP identified amongst 354 preterm infants examined over a one year period. METHODS: Information regarding gestational age, birthweight, duration of stay in nursery, duration of supplemental oxygen therapy and treatment details were obtained from discharge summary when available, and by interviewing carers...
November 7, 2016: Indian Pediatrics
https://www.readbyqxmd.com/read/27914671/current-practice-in-continuous-renal-replacement-therapy-an-epidemiological-multicenter-study
#4
T M Tomasa Irriguible, J Sabater Riera, E Poch López de Briñas, J Fort Ros, M J Lloret Cora, J Roca Antònio, A Navas Pérez, P Ortiz Ballujera, L Servià Goixart, F J González de Molina Ortiz, C Rovira Anglès, A Roglan Piqueras, M Rodríguez López
OBJECTIVE: The aim of the study is to ascertain the most relevant aspects of the current management of renal replacement therapy (RRT) in critically ill patients, and to analyze renal function recovery and mortality in patients undergoing RRT. METHODS: A non-interventional three-month observational study was made in 2012, with a follow-up period of 90 days, in 21 centers in Catalonia (Spain). Demographic information, severity scores and clinical data were obtained, as well as RRT parameters...
November 30, 2016: Medicina Intensiva
https://www.readbyqxmd.com/read/27914497/acute-management-of-stroke-patients-taking-non-vitamin-k-antagonist-oral-anticoagulants-addressing-real-world-anticoagulant-management-issues-in-stroke-aramis-registry-design-and-rationale
#5
Ying Xian, Adrian F Hernandez, Tina Harding, Gregg C Fonarow, Deepak L Bhatt, Robert E Suter, Yosef Khan, Lee H Schwamm, Eric D Peterson
BACKGROUND: Non-vitamin K antagonist oral anticoagulants (NOACs, dabigatran, rivaroxaban, apixaban, and edoxaban) have been increasingly used as alternatives to warfarin for stroke prophylaxis in patients with atrial fibrillation. Yet there is substantial lack of information on how patients on NOACs are currently treated when they have an acute ischemic stroke and the best strategies for treating intracerebral hemorrhage for those on chronic anticoagulation with warfarin or a NOAC. These are critical unmet needs for real world clinical decision making in these emergent patients...
December 2016: American Heart Journal
https://www.readbyqxmd.com/read/27914295/sarcopenia-and-post-hospital-outcomes-in-older-adults-a-longitudinal-study
#6
Mario Ulises Pérez-Zepeda, Aldo Sgaravatti, Elsa Dent
INTRODUCTION: Sarcopenia poses a significant problem for older adults, yet very little is known about this medical condition in the hospital setting. The aims of this hospital-based study were to determine: (i) the prevalence of sarcopenia; (ii) factors associated with sarcopenia; and (iii) the association of sarcopenia with adverse clinical outcomes post-hospitalisation. METHODS: This is a longitudinal analysis of consecutive patients aged ≥70 years admitted to a Geriatric Management and Evaluation Unit (GEMU) ward...
November 17, 2016: Archives of Gerontology and Geriatrics
https://www.readbyqxmd.com/read/27914274/the-adaptive-psychological-changes-of-elective-induction-of-labor-in-breastfeeding-women
#7
Vincenzo Zanardo, Martina Bertin, Laura Sansone, Laura Felice
BACKGROUND: Labor induction has been associated with breastfeeding suppression, but reasons for why this association exists have not been well determined. METHODS: We examined the influence of elective labor induction by vaginal prostaglandin at gestational week 41(+3)days on affective, cognitive, and behavioural adaptations early in puerperium and on breastfeeding pattern at 1 and 3months. RESULTS: One hundred and eighty consecutive puerperae were assigned to two groups: mothers having received vaginal prostaglandin E2 gel (Prepidil®, dinoprostone) before labor (PGE group, n=90) and mothers having received no treatment (unmedicated group, n=90)...
November 30, 2016: Early Human Development
https://www.readbyqxmd.com/read/27914240/hysterectomies-in-portugal-2000-2014-what-has-changed
#8
Inês Gante, Cláudia Medeiros-Borges, Fernanda Águas
OBJECTIVE: To describe conditions regarding hysterectomies during the past 15 years in Portugal. STUDY DESIGN: Nationwide retrospective study of women who underwent hysterectomy in Portuguese public hospitals in the period between 2000 and 2014. Patient data regarding hospital codes, geography, patient age, indications, operative techniques, associated procedures, complications, admission dates, discharge dates and 30-day postoperative readmissions were extracted from the national database with information regarding all public hospitals in Portugal...
November 21, 2016: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/27914232/resuscitation-attempts-and-duration-in-traumatic-out-of-hospital-cardiac-arrest
#9
Ben Beck, Janet E Bray, Peter Cameron, Lahn Straney, Emily Andrew, Stephen Bernard, Karen Smith
BACKGROUND: This study aimed to understand factors associated with paramedics' decision to attempt resuscitation in traumatic out-of-hospital cardiac arrest (OHCA) and to characterise resuscitation attempts ≤10min in patients who die at the scene. METHODS: The Victorian Ambulance Cardiac Arrest Registry (VACAR) was used to identify all cases of traumatic OHCA between July 2008 and June 2014. We excluded cases <16 years of age or with a mechanism of hanging or drowning...
November 30, 2016: Resuscitation
https://www.readbyqxmd.com/read/27913738/extracorporeal-membrane-oxygenation-in-transcatheter-aortic-valve-replacement
#10
Elena Dolmatova, Kasra Moazzami, Thomas P Cocke, Elie Elmann, Pranay Vaidya, Arthur F Ng, Kumar Satya, Rajeev L Narayan
BACKGROUND: Patients undergoing transcatheter aortic valve replacement can experience severe perioperative complications leading to hemodynamic instability and death. Venoarterial extracorporeal membrane oxygenation can be used to provide cardiorespiratory support during this time. METHODS: From 2012 to 2015, of 247 patients who underwent transcatheter aortic valve replacement, 6 (2.42%) required extracorporeal membrane oxygenation support. Their mean age was 82 ± 7...
December 2, 2016: Asian Cardiovascular & Thoracic Annals
https://www.readbyqxmd.com/read/27913561/hospitals-and-patients-working-in-unity-how-r-u-protocol-for-a-prospective-feasibility-study-of-telephone-peer-support-to-improve-older-patients-quality-of-life-after-emergency-department-discharge
#11
Judy A Lowthian, Alyse Lennox, Andrea Curtis, Jeremy Dale, Colette Browning, De Villiers Smit, Gillian Wilson, Debra O'Brien, Cate Rosewarne, Lee Boyd, Cath Garner, Peter Cameron
INTRODUCTION: Older people presenting to an emergency department (ED) have a higher likelihood of social isolation, loneliness and depression; which are all associated with negative health outcomes and increased health service use, including higher rates of ED attendance. The HOW R U? study aims to ascertain the feasibility and acceptability of a postdischarge telephone support programme for older ED patients following discharge. The intervention, which aims to improve quality of life, will be delivered by hospital-based volunteers...
December 2, 2016: BMJ Open
https://www.readbyqxmd.com/read/27913366/deepr-a-convolutional-net-for-medical-records
#12
Phuoc Nguyen, Truyen Tran, Nilmini Wickramasinghe, Svetha Venkatesh
Feature engineering remains a major bottleneck when creating predictive systems from electronic medical records. At present, an important missing element is detecting predictive regular clinical motifs from irregular episodic records. We present Deepr (short for Deep record), a new end-to-end deep learning system that learns to extract features from medical records and predicts future risk automatically. Deepr transforms a record into a sequence of discrete elements separated by coded time gaps and hospital transfers...
December 1, 2016: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/27913306/effect-of-bradykinin-receptor-antagonism-on-ace-inhibitor-associated-angioedema
#13
Brittany T Straka, Claudia E Ramirez, James B Byrd, Elizabeth Stone, Alencia Woodard-Grice, Hui Nian, Chang Yu, Aleena Banerji, Nancy J Brown
BACKGROUND: The B2 receptor antagonist icatibant is approved for treatment of attacks of hereditary angioedema. Icatibant has been reported to decrease time-to-resolution of angiotensin-converting enzyme (ACE) inhibitor-associated angioedema in one study of European patients. METHODS: Patients with ACE inhibitor-associated angioedema (defined as swelling of lips, tongue, pharynx or face during ACE inhibitor use and no swelling in the absence of ACE inhibitor use) were enrolled at Vanderbilt University Medical Center from October 2007 through September 2015 and at Massachusetts General Hospital in 2012...
November 29, 2016: Journal of Allergy and Clinical Immunology
https://www.readbyqxmd.com/read/27913122/-postnatal-growth-at-hospital-discharge-in-extremely-premature-newborns-in-spain
#14
Fermín García-Muñoz Rodrigo, Josep Figueras Aloy, Pedro Saavedra Santana, Alfredo García-Alix
INTRODUCTION: Postnatal growth restriction is considered a universal problem in extremely premature infants (EPI), and causes great concern due to the possible relationship between nutrition, sub-optimal postnatal growth, and neurodevelopment delay. OBJECTIVES: To describe the weight gain in EPI and to determine the changes in the length and head circumference (HC) at hospital discharge in survivors. PATIENTS AND METHODS: The study included 4,520 Caucasian EPI from single pregnancies and without severe malformations, born in the centres participating in the Spanish SEN1500 network (2002-2011)...
November 29, 2016: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
https://www.readbyqxmd.com/read/27912904/changes-of-geriatric-syndromes-in-older-adults-survived-from-intensive-care-unit
#15
Hsin-Ju Tang, Hsin-Yi Jean Tang, Fang-Wen Hu, Ching-Huey Chen
Nearly 90% of the older adult patients discharged from hospital with a cluster of geriatric syndromes. The patterns of geriatric syndromes in older adult ICU survivors are to be further explored. The aim of this study was to examine the risk factors and patterns of geriatric syndromes among older adult patients before admitting to ICU and throughout their hospitalization. A total of 137 older adult patients (age 76.9 ± 6.6; 52.6% male) participated in the study. The results showed significant increase in the occurrence of geriatric syndromes from T0 (upon ICU admission) to T1 (transition to inpatient care unit), with improvement at T2 (hospital discharge), but did not return to the baseline...
November 29, 2016: Geriatric Nursing
https://www.readbyqxmd.com/read/27912902/evolution-of-the-clinical-profile-of-patients-with-acute-heart-failure-treated-in-spanish-emergency-departments
#16
R Escoda, Ò Miró, F J Martín-Sánchez, J Jacob, P Herrero, V Gil, J M Garrido, M J Pérez-Durá, M Fuentes, P Llorens
OBJECTIVE: To analyse the changes in epidemiology, outpatient and emergency department clinical care, and outcomes of patients treated for acute heart failure (AHF) in Spanish hospital emergency departments (HEDs) between 2007 and 2014. METHOD: A multicentre cohort study was conducted that consecutively included patients with AHF diagnosed in 9HEDs during 4 periods (2007, 2009, 2011 and 2014). The study analysed the changes observed in 20 variables corresponding to baseline data, outpatient care and emergency care data and outcome data...
November 29, 2016: Revista Clínica Española
https://www.readbyqxmd.com/read/27912790/fetal-malformation-in-maternal-toxoplasma-and-rubella-co-infection-in-cameroon-a-case-report
#17
Andreas Ateke Njoh, Sarah Namondo Njoh, Messang Blandine Abizou
BACKGROUND: There has been a recent increase in the number of newborns with brain malformations due to congenital infections, but the impact of these diseases remains largely under ascertained in middle-income and low-income countries. This case report presents a fetal anencephaly following maternal toxoplasma and rubella co-infection in a resource-limited setting and the challenges faced by the patient and the health care provider in the management of the condition. CASE PRESENTATION: A 25-year-old black Cameroonian woman of Bakossi origin, gravida3 para1010, presented with a positive rubella and toxoplasma immunoglobulin G serologic test at 21 weeks of pregnancy; she could not benefit from a fetal morphologic ultrasound partly because there was none at the site of her antenatal clinic and because there were accessibility constraints getting to the nearest referral hospital approximately 100 km away...
December 3, 2016: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/27912201/anxiety-levels-of-patients-undergoing-coronary-procedures-in-the-catheterization-laboratory
#18
Ronak Delewi, Wieneke Vlastra, Wim J Rohling, Tineke C Wagenaar, Max Zwemstra, Martin G Meesterman, Marije M Vis, Joanna J Wykrzykowska, Karel T Koch, Robbert J de Winter, Jan Baan, Jan J Piek, Mirjam A G Sprangers, José P S Henriques
BACKGROUND: High levels of anxiety are associated with worse outcomes in coronary artery disease patients. Little is known about anxiety levels in patients undergoing coronary procedures. Our objective is to examine the levels of anxiety in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI) during the different phases of hospital stay and to evaluate which patient characteristics are associated with increased anxiety. METHODS: Patients undergoing CAG or PCI between April 2009 and April 2010 were included in this prospective cohort study...
November 11, 2016: International Journal of Cardiology
https://www.readbyqxmd.com/read/27912070/cardiac-complications-associated-with-the-influenza-viruses-a-subtype-h7n9-or-pandemic-h1n1-in-critically-ill-patients-under-intensive-care
#19
Jiajia Wang, Hua Xu, Xinjing Yang, Daguo Zhao, Shenlang Liu, Xue Sun, Jian-An Huang, Qiang Guo
BACKGROUND AND OBJECTIVE: The clinical presentations and disease courses of patients hospitalized with either influenza A virus subtype H7N9 (H7N9) or 2009 pandemic H1N1 influenza virus (pH1N1) were compared in a recent report, but associated cardiac complications remain unclear. The present retrospective study investigated whether cardiac complications in critically ill patients with H7N9 infections differed from those infected with the pH1N1 strain. METHODS: Suspect cases were confirmed by reverse transcription polymerase chain reaction assays with specific confirmation of the pandemic H1N1 strain at the Centers for Disease Control and Prevention...
November 29, 2016: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/27911975/transfusion-requirements-in-esrd-patients-admitted-with-gi-hemorrhage-undergoing-inpatient-endoscopy
#20
Conor McCartney, Shrihari Santosh, Setu Patolia, Sadashiv Santosh
OBJECTIVES: To date there are no studies evaluating the utilization of blood products in patients with end-stage renal disease (ESRD) with gastrointestinal (GI) hemorrhage. This study estimated transfusion needs and determined predictors available at the time of admission for patients with ESRD admitted to a university hospital with GI bleeding requiring inpatient endoscopy. METHODS: A retrospective chart review was performed on all patients with ESRD who underwent inpatient endoscopy for suspected GI bleeding between 2009 and 2015...
December 2016: Southern Medical Journal
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