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https://www.readbyqxmd.com/read/29232736/-left-ventricular-assist-device-therapy-ways-to-improve-the-ambulatory-care
#1
Caspar Burkhard-Meier, Michiel Morshuis
The use of left-ventricular assist device therapy (LVAD) in terminal heart failure patients is increasing. Many patients are receiving LVAD-therapy as final solution (destination therapy). After discharge from the implanting heart center patient-centered care has to be implemented on an outpatient basis. A responsible ambulatory treatment of this severe heart failure population requires knowledge about LVAD specific problems (general medical care, long term complications, device management). The referring cardiologist as well as the private practitioner should be more involved in the care of patients with LVAD...
December 12, 2017: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/29232349/management-of-intussusception-in-the-pediatric-emergency-department-risk-factors-for-recurrence
#2
Andrea Vo, Terry L Levin, Benjamin Taragin, Hnin Khine
BACKGROUND: The standard treatment for intussusception is air reduction enema (ARE) with inpatient observation for 24 to 48 hours to monitor for recurrence. More recent but limited observations suggest that patients who have undergone successful ARE can safely be discharged after 4 to 6 hours of observation. Our primary objective was to identify risk factors associated with early recurrence. Our secondary objectives included validating risk criteria from prior studies and identifying risk factors for ARE failures...
December 11, 2017: Pediatric Emergency Care
https://www.readbyqxmd.com/read/29231962/symptoms-reported-by-frail-elderly-adults-independently-predict-30-day-hospital-readmission-or-emergency-department-care
#3
Lynn S Borkenhagen, Rozalina G McCoy, Rachel D Havyer, Stephanie M Peterson, James M Naessens, Paul Y Takahashi
OBJECTIVES: To assess the degree to which self-reported symptoms predict unplanned readmission or emergency department (ED) care within 30 days of high-risk, elderly adults enrolled in a posthospitalization care transition program (CTP). DESIGN: Retrospective cohort study. SETTING: Posthospitalization CTP at Mayo Clinic, Rochester, Minnesota, from January 1, 2013, through March 3, 2015. PARTICIPANTS: Frail, elderly adults (N = 230; mean age 83...
December 12, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29231053/the-contribution-of-malodour-in-quality-of-life-of-patients-with-hidradenitis-suppurativa
#4
Afsaneh Alavi, Delaram Farzanfar, Rosa Kyuwon Lee, Dalal Almutairi
BACKGROUND: Malodourous discharge in patients with hidradenitis suppurativa (HS) has a strong psychosocial impact and is often reported as a source of embarrassment, low self-esteem, social stigma, and barriers to interpersonal relationships. Malodour is a maker of bacterial colonization, and its role in HS is understudied. OBJECTIVES: The aim of this study is to assess the relationship between severity of malodourous discharge and quality-of-life impairment in patients with HS...
December 1, 2017: Journal of Cutaneous Medicine and Surgery
https://www.readbyqxmd.com/read/29230961/health-and-social-factors-associated-with-a-delayed-discharge-amongst-inpatients-in-acute-geriatric-wards-a-retrospective-observational-study
#5
George Moore, Peter Hartley, Roman Romero-Ortuno
AIM: In the English National Health Service there is an increasing interest in understanding the factors associated with delayed discharges in older hospitalized adults. The present study sought to analyze whether clinical frailty was a significant and independent risk factor for having a delayed discharge when the data were controlled for potential health and social confounders. METHODS: This was a retrospective observational study in an English National Health Service teaching hospital...
December 12, 2017: Geriatrics & Gerontology International
https://www.readbyqxmd.com/read/29230540/preventing-future-fractures-effectiveness-of-an-orthogeriatric-fracture-liaison-service-compared-to-an-outpatient-fracture-liaison-service-and-the-standard-management-in-patients-with-hip-fracture
#6
Antonio Naranjo, Sonia Fernández-Conde, Soledad Ojeda, Laura Torres-Hernández, Carolina Hernández-Carballo, Idoia Bernardos, Sinforiano Rodríguez, Pedro Laynez
An observational study was carried out in two hospitals in patients > 65 years admitted for hip fracture. At 6 months, 15% of patients in the hospital with orthogeriatric standard care and 75% in the hospital with fracture liaison service were receiving bisphosphonates. PURPOSE: Many patients with fractures are discharged without preventive therapy against further fractures. We sought to compare the effectiveness of an orthogeriatric fracture liaison service (FLS), outpatient FLS, and the standard care after hip fractures in prevention of future fractures...
December 11, 2017: Archives of Osteoporosis
https://www.readbyqxmd.com/read/29230400/perspectives-of-post-acute-transition-of-care-for-cardiac-surgery-patients
#7
REVIEW
Nicoleta Stoicea, Tian You, Andrew Eiterman, Clifton Hartwell, Victor Davila, Stephen Marjoribanks, Cristina Florescu, Sergio Daniel Bergese, Barbara Rogers
Post-acute care (PAC) facilities improve patient recovery, as measured by activities of daily living, rehabilitation, hospital readmission, and survival rates. Seamless transitions between discharge and PAC settings continue to be challenges that hamper patient outcomes, specifically problems with effective communication and coordination between hospitals and PAC facilities at patient discharge, patient adherence and access to cardiac rehabilitation (CR) services, caregiver burden, and the financial impact of care...
2017: Frontiers in Cardiovascular Medicine
https://www.readbyqxmd.com/read/29229712/payment-incentives-for-community-based-psychiatric-care-in-ontario-canada
#8
David Rudoler, Claire de Oliveira, Joyce Cheng, Paul Kurdyak
BACKGROUND: In September 2011, the government of Ontario implemented payment incentives to encourage the delivery of community-based psychiatric care to patients after discharge from a psychiatric hospital admission and to those with a recent suicide attempt. We evaluated whether these incentives affected supply of psychiatric services and access to care. METHODS: We used administrative data to capture monthly observations for all psychiatrists who practised in Ontario between September 2009 and August 2014...
December 11, 2017: CMAJ: Canadian Medical Association Journal, Journal de L'Association Medicale Canadienne
https://www.readbyqxmd.com/read/29229566/agreement-between-parent-proxy-and-child-self-report-of-pain-intensity-and-health-related-quality-of-life-after-surgery
#9
Brooke E Lifland, Rita Mangione-Smith, Tonya M Palermo, Jennifer A Rabbitts
OBJECTIVES: Monitoring patient-centered health outcomes after hospital discharge is important for identifying patients experiencing poor recovery after surgery. Utilizing parent reports may improve the feasibility of monitoring recovery when children are not available to provide self-report. We therefore aimed to examine agreement between parent and child reports of child pain and health-related quality of life (HRQOL) in children after hospital discharge from inpatient surgery. METHODS: 295 children aged 8-18 years and their parents reported on child pain intensity using an 11-point Numerical Rating Scale and on HRQOL using the 0-to-100 point Pediatric Quality of Life Inventory Version 4...
December 8, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/29229451/more-clinical-mimics-of-infant-botulism
#10
Jessica M Khouri, Jessica R Payne, Stephen S Arnon
OBJECTIVE: To ascertain the actual diagnoses of 76 patients (2005-2015) whose clinical presentations so closely resembled infant botulism that the patients were treated with Human Botulism Immune Globulin Intravenous (BIG-IV; BabyBIG), but whose illnesses subsequently were not laboratory confirmed as infant botulism ("clinical mimics" of infant botulism). STUDY DESIGN: The California Department of Public Health produces BIG-IV and distributes it nationwide as a public service (ie, not-for-profit) orphan drug to treat patients hospitalized with suspected infant botulism...
December 8, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/29229437/the-epidemiology-of-hip-fractures-across-western-victoria-australia
#11
Kara L Holloway, Muhammad A Sajjad, Mohammadreza Mohebbi, Mark A Kotowicz, Patricia M Livingston, Mustafa Khasraw, Sharon Hakkennes, Trisha L Dunning, Susan Brumby, Richard S Page, Daryl Pedler, Alasdair Sutherland, Svetha Venkatesh, Sharon L Brennan-Olsen, Lana J Williams, Julie A Pasco
BACKGROUND: Hip fractures are associated with considerable morbidity and mortality. Hip fracture incidence varies across different levels of accessibility/remoteness and socioeconomic status (SES). As part of the Ageing, Chronic Disease and Injury Study, we aimed to map the pattern of hip fractures across the western region of the Australian state of Victoria, which contains a range of remoteness levels and SES. METHODS: Data on hip fractures resulting in hospital admission were extracted from the Victorian Admitted Episodes Dataset (VAED) for men and women aged 40+years during 2010-2013 inclusive...
December 8, 2017: Bone
https://www.readbyqxmd.com/read/29229238/effectiveness-of-an-automated-digital-remote-guidance-and-telemonitoring-platform-on-costs-readmissions-and-complications-after-hip-and-knee-arthroplasties
#12
Benjamin I Rosner, Marc Gottlieb, William N Anderson
BACKGROUND: The impact of a new class of automated digital patient engagement (DPE) platforms on potentially avoidable costs, hospital admissions, and complications after discharge following hip and knee arthroplasties has not been established. METHODS: We conducted a multicenter observational cohort study comparing claims data for potentially avoidable costs, hospital admissions, and complications for 90 days after discharge following hip and knee arthroplasties at 10 practice sites in CA and NV...
December 2, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29229155/use-of-game-theory-to-model-patient-engagement-after-surgery-a-qualitative-analysis
#13
Stephen A Castellanos, Gerardo Buentello, Diana Gutierrez-Meza, Angela Forgues, Lisa Haubert, Avo Artinyan, Cameron L Macdonald, James W Suliburk
BACKGROUND: Patient engagement is challenging to define and operationalize. Qualitative analysis allows us to explore patient perspectives on this topic and establish themes. A game theoretic signaling model also provides a framework through which to further explore engagement. METHODS: Over a 6-mo period, thirty-eight interviews were conducted within 6 wk of discharge in patients undergoing thyroid, parathyroid, or colorectal surgery. Interviews were transcribed, anonymized, and analyzed using the NVivo 11 platform...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29229128/thirty-day-readmission-and-mortality-among-medicare-beneficiaries-discharged-to-skilled-nursing-facilities-after-vascular-surgery
#14
Sara Fernandes-Taylor, Stephen Berg, Rebecca Gunter, Kyla Bennett, Maureen A Smith, Paul J Rathouz, Caprice C Greenberg, K Craig Kent
BACKGROUND: Readmission within 30 d of an acute hospital stay is frequent, costly, and increasingly subject to penalties. Early readmission is most common after vascular surgery; these patients are often discharged to skilled nursing facilities (SNFs), making postacute care an essential partner in reducing readmissions. We characterize 30-day readmissions among vascular surgery patients discharged to SNF to provide evidence for this understudied segment of readmission after specialty surgery...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29229119/weaker-gun-state-laws-are-associated-with-higher-rates-of-suicide-secondary-to-firearms
#15
Rodrigo F Alban, Miriam Nuño, Ara Ko, Galinos Barmparas, Azaria V Lewis, Daniel R Margulies
BACKGROUND: Firearm-related suicides comprise over two-thirds of gun-related violence in the United States, and gun laws and policies remain under scrutiny, with many advocating for revision of the regulatory map for lawful gun ownership, aiming at restricting access and distribution of these weapons. However, the quantitative relationship between how strict gun laws are and the incidence of firearm violence with their associated mortality is largely unknown. We therefore, sought to explore the impact of firearm law patterns among states on the incidence and outcomes of firearm-related suicide attempts, utilizing established objective criteria...
January 2018: Journal of Surgical Research
https://www.readbyqxmd.com/read/29229044/the-commercialization-of-patient-related-decision-making-in-hospitals
#16
Karl-Heinz Wehkamp, Heinz Naegler
BACKGROUND: Hospitals must make a profit to ensure their continued existence. The observed rises in case numbers and case-mix indices lead us to suspect that the admission, treatment, and discharge of patients are now being influenced not just by purely medical factors, but also by economic considerations with a view toward making a profit-i.e., that decision-making has become partially commercialized. In this study, we investigated whether doctors and hospital chief executive officers (CEOs) share this perception of their professional environment...
November 24, 2017: Deutsches Ärzteblatt International
https://www.readbyqxmd.com/read/29228945/trends-in-incidence-of-proximal-humerus-fractures-surgical-procedures-and-outcomes-among-elderly-hospitalized-patients-with-and-without-type-2-diabetes-in-spain-2001-2013
#17
Maria Angeles Martinez-Huedo, Rodrigo Jiménez-García, Eduardo Mora-Zamorano, Valentín Hernández-Barrera, Manuel Villanueva-Martinez, Ana Lopez-de-Andres
BACKGROUND: Several studies have reported that diabetic persons have an increased risk for fractures than non-diabetes patients. The association between proximal humerus fractures and type 2 diabetes (T2DM) is unclear and some studies point to insulin treatment, hypoglycaemic episodes consequently to inadequate control of diabetes or, more recently, to an alteration of trabecular bone. We examined trends in the incidence of proximal humerus fractures, surgical procedures and outcomes among hospitalized patients aged ≥65 years, with and without T2DM in Spain, 2001-2013...
December 11, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/29228939/the-ethics-of-caring-for-hospital-dependent-patients
#18
Calvin Sung, Jennifer L Herbst
BACKGROUND: Hospital-dependent patients are individuals who are repeatedly readmitted to the hospital because their acute medical needs cannot be met elsewhere. Unlike the chronically critically ill, these patients do not have a continuous need for life-sustaining equipment and can experience periods of relative stability where they have a good quality of life. However, some end up spending months or even years in the hospital receiving resource-intensive care because they are unable to be safely discharged, despite an initial optimistic prognosis...
December 11, 2017: BMC Medical Ethics
https://www.readbyqxmd.com/read/29228894/is-therapeutic-hypothermia-during-neonatal-extracorporeal-membrane-oxygenation-associated-with-intracranial-hemorrhage
#19
Katherine Cashen, Ron W Reeder, Christina Shanti, Heidi J Dalton, J Michael Dean, Kathleen L Meert
INTRODUCTION: The use of therapeutic hypothermia during neonatal extracorporeal membrane oxygenation (ECMO) as a neurologic protective strategy has gained interest among clinicians despite limited data. Our objective is to describe the relationship between the use of therapeutic hypothermia during neonatal ECMO and complications, mortality and functional status among survivors. METHODS: Secondary analysis of data collected by the Collaborative Pediatric Critical Care Research Network between December 2012 and September 2014...
December 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29228363/testing-for-coccidioidomycosis-in-emergency-departments-in-arizona
#20
Mohammed A Khan, Shane Brady, Ken K Komatsu
Testing practices for coccidioidomycosis in the emergency department are poorly understood. We described characteristics of patients tested for coccidioidomycosis in emergency departments in Arizona and examined coccidioidomycosis testing among community-acquired pneumonia (CAP) patients. Emergency department visit records for patients tested for coccidioidomycosis and CAP patients were extracted from the Arizona hospital discharge database. In sum, 2.8% of CAP patients were tested for coccidioidomycosis. The proportion of patients tested varied substantially by healthcare facility and provider...
December 8, 2017: Medical Mycology: Official Publication of the International Society for Human and Animal Mycology
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