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https://www.readbyqxmd.com/read/28549165/impact-of-antimicrobial-stewardship-for-pediatric-outpatient-parenteral-antibiotic-therapy
#1
Adam L Hersh, Jared Olson, Chris Stockmann, Emily A Thorell, Elizabeth D Knackstedt, Lawanda Esquibel, Susan Sanderson, Andrew T Pavia
We developed an outpatient parenteral antibiotic therapy (OPAT) stewardship program in a freestanding children's hospital to improve the appropriateness of OPAT prescribing. Introduction of the program enabled expert review of nearly 90% of the patients being prepared for discharge with OPAT and was associated with a 24% reduction in OPAT use.
May 26, 2017: Journal of the Pediatric Infectious Diseases Society
https://www.readbyqxmd.com/read/28549050/use-of-noncontact-low-frequency-ultrasound-in-deep-tissue-pressure-injury-a-retrospective-analysis
#2
Pamela Wagner-Cox, Heather M Duhame, Christina R Jamison, Robin R Jackson, Suzy T Fehr
PURPOSE: The purpose of this study was to examine the effect of noncontact low-frequency ultrasound (NLFU) on deep tissue pressure injury (DTPI), both hospital-acquired and those present on admission (POA). DESIGN: Retrospective, descriptive study. SAMPLE AND SETTING: Medical records from 44 adult patients with a DTPI treated with NLFU were reviewed; 22 had a hospital-acquired DTPI (HADTPI) and 22 had DTPI POA. Their mean age was 71.3 ± 16...
May 25, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28549029/a-contemporary-approach-to-reoperative-aortic-valve-surgery-when-is-less-more
#3
Deane E Smith, Michael S Koeckert, Patrick F Vining, Elias A Zias, Eugene A Grossi, Aubrey C Galloway
OBJECTIVE: Although the benefits of minimally invasive valvular surgery are well established, the applicability of extending these techniques to reoperative aortic valve surgery is unknown. We evaluated our experience with a minimally invasive approach to this patient population. METHODS: From January 2010 to September 2015, 21 patients underwent reoperative isolated aortic valve replacement via a minimally invasive approach by a single surgeon. All patients had preoperative evaluation with computerized tomography and coronary catheterization...
May 25, 2017: Innovations: Technology and Techniques in Cardiothoracic and Vascular Surgery
https://www.readbyqxmd.com/read/28549024/the-epidemiology-of-hospital-death-following-pediatric-severe-sepsis-when-why-and-how-children-with-sepsis-die
#4
Scott L Weiss, Fran Balamuth, Josey Hensley, Julie C Fitzgerald, Jenny Bush, Vinay M Nadkarni, Neal J Thomas, Mark Hall, Jennifer Muszynski
OBJECTIVE: The epidemiology of in-hospital death after pediatric sepsis has not been well characterized. We investigated the timing, cause, mode, and attribution of death in children with severe sepsis, hypothesizing that refractory shock leading to early death is rare in the current era. DESIGN: Retrospective observational study. SETTING: Emergency departments and ICUs at two academic children's hospitals. PATIENTS: Seventy-nine patients less than 18 years old treated for severe sepsis/septic shock in 2012-2013 who died prior to hospital discharge...
May 25, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28549013/effect-of-preoperative-diabetes-management-on-glycemic-control-and-clinical-outcomes-after-elective-surgery
#5
Rajesh Garg, Brooke Schuman, Angela Bader, Shelley Hurwitz, Alexander Turchin, Patricia Underwood, Cheyenne Metzger, Raquel Rein, Meghan Lortie
OBJECTIVE: The aim of this study was to evaluate whether preoperative diabetes management can improve glycemic control and clinical outcomes after elective surgery. BACKGROUND: There is lack of data on the importance of diabetes treatment before elective surgery. Diabetes is often ignored before surgery and aggressively treated afterwards. METHODS: Patients with diabetes were identified and treated proactively before their scheduled surgeries...
May 25, 2017: Annals of Surgery
https://www.readbyqxmd.com/read/28549000/a-comparison-of-anterior-and-posterior-lumbar-interbody-fusions-complications-readmissions-discharge-dispositions-and-costs
#6
Rabia Qureshi, Varun Puvanesarajah, Amit Jain, Adam L Shimer, Francis H Shen, Hamid Hassanzadeh
STUDY DESIGN: Retrospective Database Review OBJECTIVE.: To understand medical complication rates, readmission rates, costs and discharge dispositions in ALIFs versus TLIF/PLIFs for lumbar degenerative disease. SUMMARY OF BACKGROUND DATA: Indications for anterior (ALIFs) vs posterior lumbar interbody fusions (PLIFs) can vary, though benefits of anterior approach surgery include full access to the anterior column and ability to place fusion devices. METHODS: The PearlDiver Database of Medicare records was utilized for this retrospective database review...
May 25, 2017: Spine
https://www.readbyqxmd.com/read/28548607/nutritional-risk-and-nutritional-status-at-admission-and-discharge-among-chinese-hospitalized-patients-a-prospective-nationwide-multicenter-study
#7
Mingwei Zhu, Junmin Wei, Wei Chen, Xin Yang, Hongyuan Cui, Sainan Zhu
OBJECTIVE: The objective of this study was to assess nutritional risk and status of Chinese hospitalized patients at admission and discharge and relations with clinical outcomes. METHODS: A prospective, nationwide, multicenter study was conducted from June to September 2014 in 34 large hospitals in 18 cities in China. Patients ≥ 18 years with a hospital stay of 7-30 days were recruited. Anthropometric and laboratory indicators, nutritional risk screening, and assessment by Nutritional Risk Screening 2002 (NRS 2002) and subjective global assessment (SGA) were performed within 24 hours of admission and discharge...
May 26, 2017: Journal of the American College of Nutrition
https://www.readbyqxmd.com/read/28548595/effect-of-treatment-modality-on-in-hospital-outcome-in-patients-with-subarachnoid-hemorrhage-a-nationwide-study-in-japan-j-aspect-study
#8
Ryota Kurogi, Akiko Kada, Kunihiro Nishimura, Satoru Kamitani, Ataru Nishimura, Tetsuro Sayama, Jyoji Nakagawara, Kazunori Toyoda, Kuniaki Ogasawara, Junichi Ono, Yoshiaki Shiokawa, Toru Aruga, Shigeru Miyachi, Izumi Nagata, Shinya Matsuda, Shinichi Yoshimura, Kazuo Okuchi, Akifumi Suzuki, Fumiaki Nakamura, Daisuke Onozuka, Akihito Hagihara, Koji Iihara
OBJECTIVE Although heterogeneity in patient outcomes following subarachnoid hemorrhage (SAH) has been observed across different centers, the relative merits of clipping and coiling for SAH remain unknown. The authors sought to compare the patient outcomes between these therapeutic modalities using a large nationwide discharge database encompassing hospitals with different comprehensive stroke center (CSC) capabilities. METHODS They analyzed data from 5214 patients with SAH (clipping 3624, coiling 1590) who had been urgently hospitalized at 393 institutions in Japan in the period from April 2012 to March 2013...
May 26, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28548592/intracranial-pressure-monitoring-in-severe-blunt-head-trauma-does-the-type-of-monitoring-device-matter
#9
Alberto Aiolfi, Desmond Khor, Jayun Cho, Elizabeth Benjamin, Kenji Inaba, Demetrios Demetriades
OBJECTIVE Intracranial pressure (ICP) monitoring has become the standard of care in the management of severe head trauma. Intraventricular devices (IVDs) and intraparenchymal devices (IPDs) are the 2 most commonly used techniques for ICP monitoring. Despite the widespread use of these devices, very few studies have investigated the effect of device type on outcomes. The purpose of the present study was to compare outcomes between 2 types of ICP monitoring devices in patients with isolated severe blunt head trauma...
May 26, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28548455/liminality-in-the-occupational-identity-of-mental-health-peer-support-workers-a-qualitative-study
#10
Alan Simpson, Candice Oster, Eimear Muir-Cochrane
Peer support is increasingly provided as a component of mental health care, where people in recovery from mental health problems use their lived experiences to provide support to those experiencing similar difficulties. In the present study, we explored the evolution of peer support workers' (PSW) occupational identities. A qualitative study was undertaken alongside a pilot randomized, controlled trial of peer support for service users discharged from a mental hospital in London, UK. Two focus groups were conducted with eight PSW...
May 26, 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/28547859/giant-cell-tumor-of-the-mobile-spine-occurring-in-pregnancy-a-case-report-and-literature-review
#11
Kai Zheng, Ming Xu, Bing Wang, Xiu-Chun Yu, Yong-Cheng Hu
Giant cell tumor (GCT) is a benign, locally aggressive tumor that rarely occurs in the spine. They usually occur in patients between 20 and 40 years of age; some patients with GCT present in hospital with pregnancy. The management of these patients can be challenging. The current study reports a case of GCT located in the sixth thoracic vertebra of a 31-year-old female at 34 weeks of gestation. An osteolytic lesion, 3.5 cm × 3.5 cm in diameter, was identified on CT. An MRI test of the lesion revealed a soft tissue mass involving the T 6-7 vertebrae, extending to the right pedicle of the T 6 vertebra and causing significant spinal cord compression...
May 26, 2017: Orthopaedic Surgery
https://www.readbyqxmd.com/read/28547724/costs-associated-with-community-acquired-pneumonia-in-france
#12
Grèce Saba, Luiz Flavio Andrade, Jacques Gaillat, Pierre Bonnin, Christian Chidiac, Hajnal-Gabriela Illes, Henri Laurichesse, Jonathan Messika, Jean-Damien Ricard, Bruno Detournay, Patrick Petitpretz, Gérard de Pouvourville
OBJECTIVES: Pneumocost is a prospective study that aimed at documenting the costs of the management of patients hospitalized with a pneumococcal pneumonia and the post-discharge costs during a 6-month period in the French context. METHODS: Billing data were used to document hospital costs. Resource use during the follow-up period was collected through phone interviews at month 1, 3 and 6. Descriptive statistics and multivariate analyses were performed. We used generalized linear models with log-link functions to estimate parameters associated with hospital and follow-up costs of patients...
May 25, 2017: European Journal of Health Economics: HEPAC: Health Economics in Prevention and Care
https://www.readbyqxmd.com/read/28547207/role-of-out-of-hours-primary-care-service-in-limiting-inappropriate-access-to-emergency-department
#13
Andrea Posocco, Maria Paola Scapinello, Irene De Ronch, Francesco Castrogiovanni, Gianluca Lollo, Guglielmo Sergi, Iginio Tomaselli, Loris Tonon, Marco Solmi, Daniele Pescador, Elena Battistuz, Stefano Traversa, Vincenzo Zambianco, Nicola Veronese
Out of hours (OOH) doctors can have an important gate-keeping role over the access to the emergency department (ED), but the outcome and the quality of their ED referrals have been poorly studied. We aimed to investigate the outcome of patients referred to ED from OOH service and the determinants of admission or short-stay dispositions. We collected retrospectively data about referrals to ED from a local OOH service in the north-east of Italy using the OOH paper register and the ED electronic database, over the period of 01/10/2012 to 31/03/2013...
May 25, 2017: Internal and Emergency Medicine
https://www.readbyqxmd.com/read/28546861/association-between-recurrence-of-acute-kidney-injury-and-mortality-in-intensive-care-unit-patients-with-severe-sepsis
#14
Emilio Rodrigo, Borja Suberviola, Miguel Santibáñez, Lara Belmar, Álvaro Castellanos, Milagros Heras, Juan Carlos Rodríguez-Borregán, Angel Luis Martín de Francisco, Claudio Ronco
BACKGROUND: Acute kidney injury (AKI) occurs in more than half critically ill patients admitted in intensive care units (ICU) and increases the mortality risk. The main cause of AKI in ICU is sepsis. AKI severity and other related variables such as recurrence of AKI episodes may influence mortality risk. While AKI recurrence after hospital discharge has been recently related to an increased risk of mortality, little is known about the rate and consequences of AKI recurrence during the ICU stay...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28546753/protocol-for-management-after-thyroidectomy-a-retrospective-study-based-on-one-center-experience
#15
Han Luo, Hongliu Yang, Tao Wei, Yanping Gong, Anping Su, Yu Ma, Xiuhe Zou, Jianyong Lei, Wanjun Zhao, Jingqiang Zhu
BACKGROUND AND AIM: The optimal approach to detect and treat symptomatic hypocalcemia (SxH) after thyroidectomy is still uncertain. In our retrospective study, we sought to set a standardized postoperative management protocol on the basis of relative change of parathyroid hormone (PTH) and absolute value of postoperative day 1 (POD1) PTH. METHODS: Patients who underwent thyroidectomy were identified retrospectively in our prospective database. Blood was collected 1 day before surgery and on POD1...
2017: Therapeutics and Clinical Risk Management
https://www.readbyqxmd.com/read/28546303/intraocular-minocycline-for-the-treatment-of-ocular-pythiosis
#16
Fátima Ros Castellar, Carmen Sobrino Jiménez, Almudena Del Hierro Zarzuelo, Alicia Herrero Ambrosio, Ana Boto de Los Bueis
PURPOSE: A case of ocular pythiosis successfully treated with surgery and intraocular and oral minocycline is reported. SUMMARY: A 30-year-old man who wore corrective contact lenses traveled to Brazil and Colombia where he swam in salt and fresh waters while wearing contact lenses. He sought treatment at an emergency department after 2 weeks of suffering with a painful corneal ulcer, redness, and loss of vision in his right eye that had been treated at other centers with ophthalmic moxifloxacin for 10 days and with fortified topical antibiotics (amikacin and vancomycin) for 2 days...
June 1, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28546122/cauda-equina-syndrome-due-to-dural-sac-shift-with-engorgement-of-the-epidural-venous-plexus-rare-complication-after-lumbar-microdiscectomy
#17
Yoshinori Maki, Motohiro Takayama, Hideki Hayashi, Yohei Yokoyama, Yuji Agawa
BACKGROUND: Several postoperative complications related to lumbar microdisectomy have been reported, including cauda equina syndrome. However, to the best of our knowledge, postoperative cauda equina syndrome resulting from dural sac shift with engorgement of the epidural venous plexus is yet to be reported. CASE DESCRIPTION: A 71-year-old male patient was referred to our hospital with a chief complaint of pain and sensory disturbance due to the lumbar disc herniation of L5-S1...
May 22, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28546016/timing-on-echocardiography-and-blood-laboratory-test-is-important-for-future-outcome-association-in-hospitalized-heart-failure-patients
#18
Li-Tan Yang, Yuichiro Kado, Yasufumi Nagata, Kyoko Otani, Yutaka Otsuji, Masaaki Takeuchi
BACKGROUND: We investigated whether both echocardiography and blood examination parameters obtained before discharge are more closely associated with adverse events than those obtained upon admission in hospitalized heart failure (HF) patients. METHODS: We retrospectively selected 267 hospitalized HF patients who underwent comprehensive transthoracic echocardiography (TTE) within 2 days of admission (n=223) and/or within 7 days of discharge (n=157). Blood test results were also collected at the same time window...
May 22, 2017: Journal of Cardiology
https://www.readbyqxmd.com/read/28545926/lost-workdays-and-healthcare-use-before-and-after-hospital-visits-due-to-rotavirus-and-other-gastroenteritis-among-young-children-in-norway
#19
Christina H Edwards, Terese Bekkevold, Elmira Flem
BACKGROUND: Cost-effectiveness of rotavirus vaccination is affected by assumptions used in health economic evaluations. To inform such evaluations, we assessed healthcare use before and after hospitalisations due to rotavirus and other acute gastroenteritis (AGE) among children <5years of age in Norway and estimated daycare and work absenteeism. METHODS: We conducted post-discharge interviews with caregivers of 282 children hospitalised with AGE at two hospitals in Norway during April 2014-February 2017...
May 22, 2017: Vaccine
https://www.readbyqxmd.com/read/28545885/evaluation-of-the-yale-new-haven-readmission-risk-score-for-pneumonia-in-a-general-hospital-population
#20
Gabrielle Schaefer, Robert El-Kareh, Jennifer Quartarolo, Gregory Seymann
BACKGROUND: The Yale New Haven Readmission Risk Score (YNHRRS) for pneumonia is a clinical prediction tool developed to assess risk for 30-day readmission. This tool was validated in a cohort of Medicare patients; generalizability to a broader patient population has not been evaluated. In addition, it lacks indicators of functional status or social support, which have been shown to be predictors of readmission in other studies. OBJECTIVE: To evaluate the generalizability of the YNHRRS for pneumonia in a general population of hospitalized patients, and assess the impact of incorporating measures of functional status and social support on its predictive value...
May 22, 2017: American Journal of Medicine
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