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https://www.readbyqxmd.com/read/29144812/increased-bone-turnover-in-type-2-diabetes-patients-randomized-to-bariatric-surgery-vs-medical-therapy-at-5-years
#1
Megan R Crawford, Nathan Pham, Leila Khan, James F Bena, Philip R Schauer, Sangeeta R Kashyap
OBJECTIVE: The aim of our study was to determine the 5 year outcomes of bariatric surgery vs. intensive medical therapy on bone turnover in patients with type 2 diabetes (T2DM) from the STAMPEDE trial. METHODS: This is an ancillary investigation of a 5 year randomized control trial at a single tertiary care center involving 95 patients aged 48.5 ± 8 years with obesity (BMI: 36.5±3.6 kg/m(2)) and uncontrolled T2DM (HbA1C: 9.3 ±1.6%). Patients were randomized to intensive medical therapy (IMT; N=25), Roux-en-Y gastric bypass (RYGB; N=37), or sleeve gastrectomy (SG; N=33) for diabetes treatment...
November 16, 2017: Endocrine Practice
https://www.readbyqxmd.com/read/29144406/evaluating-differences-in-aluminum-exposure-through-parenteral-nutrition-in-neonatal-morbidities
#2
Megan Fortenberry, Lela Hernandez, Jacob Morton
Aluminum is a common contaminant in many components of parenteral nutrition, especially calcium and phosphate additives. Although long-term effects have been described in the literature, short-term effects are not well-known. Currently, the Food and Drug Administration recommends maintaining aluminum at <5 mcg/kg/day. This was a single center, retrospective case-control study of 102 neonatal intensive care unit patients. Patients were included if they had a diagnosis of necrotizing enterocolitis, rickets/osteopenia, or seizures and received at least 14 days of parenteral nutrition...
November 16, 2017: Nutrients
https://www.readbyqxmd.com/read/29144194/an-integrative-behavioral-health-care-model-using-automated-sbirt-and-care-coordination-in-community-health-care
#3
Ronald Dwinnells, Lauren Misik
Efficient and effective integration of behavioral health programs in a community health care practice emphasizes patient-centered medical home principles to improve quality of care. A prospective, 3-period, interrupted time series study was used to explore which of 3 different integrative behavioral health care screening and management processes were the most efficient and effective in prompting behavioral health screening, identification, interventions, and referrals in a community health practice. A total of 99...
November 1, 2017: Journal of Primary Care & Community Health
https://www.readbyqxmd.com/read/29143960/predicting-frequent-emergency-department-use-among-children-with-epilepsy-a-retrospective-cohort-study-using-electronic-health-data-from-2-centers
#4
Zachary M Grinspan, Anup D Patel, Baria Hafeez, Erika L Abramson, Lisa M Kern
OBJECTIVE: Among children with epilepsy, to develop and evaluate a model to predict emergency department (ED) use, an indicator of poor disease control and/or poor access to care. METHODS: We used electronic health record data from 2013 to predict ED use in 2014 at 2 centers, benchmarking predictive performance against machine learning algorithms. We evaluated algorithms by calculating the expected yearly ED visits among the 5% highest risk individuals. We estimated the breakeven cost per patient per year for an intervention that reduced ED visits by 10%...
November 16, 2017: Epilepsia
https://www.readbyqxmd.com/read/29143935/a-propensity-matched-comparison-of-hard-outcomes-in-children-on-chronic-dialysis
#5
Enrico Vidal, Nicholas C Chesnaye, Fabio Paglialonga, Bruno Minale, Giovanna Leozappa, Mario Giordano, Bruno Gianoglio, Ciro Corrado, Rosa Maria Roperto, Roberto Chimenz, Francesca Mencarelli, Ilse-Maria Ratsch, Luisa Murer, Enrico Verrina
Data concerning outcomes of children on hemodialysis (HD) and peritoneal dialysis (PD) are scarce and frequently derived from single-center experiences. We sought to compare survival and transplantation rates in a large cohort of PD and HD patients. We extracted all patients initiating dialysis under 16 years of age between 2004 and 2013 from the Italian Registry of Pediatric Chronic Dialysis. Patients on PD were propensity-matched to those on HD based on gender, age, primary cause of ESRD, and the number of co-morbidities...
November 16, 2017: European Journal of Pediatrics
https://www.readbyqxmd.com/read/29143900/an-innovative-mobile-health-system-to-improve-and-standardize-antenatal-care-among-underserved-communities-a-feasibility-study-in-an-italian-hosting-center-for-asylum-seekers
#6
Lucia Borsari, Giovanna Stancanelli, Laura Guarenti, Teresa Grandi, Serena Leotta, Lucia Barcellini, Paola Borella, Anne Caroline Benski
Innovative migrant-friendly tools are needed to assist health personnel manage the high number of pregnancies within reception centers. This study tests functionality and acceptability of a new mHealth system in providing antenatal care amongst migrants. The study, carried out between 2014 and 2016, involved 150 pregnant women residing in the largest European migrant reception center in Sicily. A ticket tracking system assessed the system's functionality and a questionnaire assessed women's acceptability. The system facilitated the collection of clinical data, enabling the creation of electronic patient records and identifying 10% of pregnancies as high-risk...
November 16, 2017: Journal of Immigrant and Minority Health
https://www.readbyqxmd.com/read/29143629/from-erasure-to-opportunity-a-qualitative-study-of-the-experiences-of-transgender-men-around-pregnancy-and-recommendations-for-providers
#7
Alexis Hoffkling, Juno Obedin-Maliver, Jae Sevelius
BACKGROUND: Some transgender men retain their uterus, get pregnant, and give birth. However, societal attitudes about gender have erected barriers to openly being pregnant and giving birth as a transgender man. Little research exists regarding transgender men's reproductive needs. Anecdotal observations suggest that social change and increasing empowerment of transgender men may result in increasing frequency and openness about pregnancy and birth. Specific needs around conception, pregnancy, and newborn care may arise from transphobia, exogenous testosterone exposure, or from having had (or desiring) gender-affirming surgery...
November 8, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/29143487/nurses-implementation-of-ventilator-associated-pneumonia-prevention-guidelines-an-observational-study-in-jordan
#8
Sami M Aloush
BACKGROUND: Ventilator-associated pneumonia prevention guidelines from the Center for Disease Control and Prevention, the American Thoracic Society, and the Institute for Health Care and Improvement have been published to reduce the rate of ventilator-associated pneumonia in the clinical settings; however, nurses' compliance with these guidelines is still questionable. AIMS: The purpose of this study was to assess nurses' compliance with ventilator-associated pneumonia prevention guidelines and the factors that influence their compliance...
November 15, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/29143161/point-of-care-b-type-natriuretic-peptide-and-portable-echocardiography-for-assessment-of-patients-with-suspected-heart-failure-in-primary-care-rationale-and-design-of-the-three-part-handheld-bnp-program-and-results-of-the-training-study
#9
Caroline Morbach, Thomas Buck, Christian Rost, Sebastian Peter, Stephan Günther, Stefan Störk, Christiane Prettin, Raimund Erbel, Georg Ertl, Christiane E Angermann
BACKGROUND: Patients with suspected heart failure (HF) often present first to general practitioners (GPs). Timely and accurate HF diagnosis and reliable prognostic information have remained unmet goals in primary care, where patient evaluation often relies on clinical assessment only. The Handheld-BNP program investigates whether additional use of portable echocardiography (ECHO) and point-of-care determination of B-type natriuretic peptide (BNP) improves the accuracy of HF diagnosis and aids risk prediction in primary care...
November 15, 2017: Clinical Research in Cardiology: Official Journal of the German Cardiac Society
https://www.readbyqxmd.com/read/29143092/laparoscopic-appendectomy-minimally-invasive-surgery-training-improves-outcomes-in-basic-laparoscopic-procedures
#10
Katherine D Gray, Joshua G Burshtein, Lama Obeid, Maureen D Moore, Gregory Dakin, Alfons Pomp, Cheguevara Afaneh
BACKGROUND: To determine whether minimally invasive surgery (MIS) training improves outcomes in laparoscopic appendectomy, a procedure that is commonly performed in general surgery training. METHODS: Retrospective review was conducted of all patients undergoing laparoscopic appendectomy for suspected acute appendicitis between 2014 and 2015 at a single-center, tertiary-care academic institution. Patients operated on by MIS-trained surgeons (MIS group) were compared to those operated on by general surgeons (GS group)...
November 15, 2017: World Journal of Surgery
https://www.readbyqxmd.com/read/29142964/impact-of-the-end-stage-renal-disease-prospective-payment-system-on-the-use-of-peritoneal-dialysis
#11
Qian Zhang, Mae Thamer, Onkar Kshirsagar, Yi Zhang
Introduction: The End Stage Renal Disease (ESRD) Prospective Payment System (PPS), implemented by the Centers for Medicare and Medicaid Services in January 2011, encouraged use of peritoneal dialysis (PD) through various financial incentives. Our goal was to determine whether PPS effectively increased PD use in incident dialysis patients. Methods: Our study used the United States Renal Data System (USRDS) to identify 430,927 adult patients who initiated dialysis between 2009 and 2012...
May 2017: KI Reports
https://www.readbyqxmd.com/read/29142955/improving-the-prediction-of-cardiac-surgery-associated-acute-kidney-injury
#12
Jordan Crosina, Jordyn Lerner, Julie Ho, Navdeep Tangri, Paul Komenda, Brett Hiebert, Nora Choi, Rakesh C Arora, Claudio Rigatto
Introduction: Acute kidney injury (AKI) is a potentially fatal complication of cardiac surgery. The inability to predict cardiac surgery-associated AKI is a major barrier to prevention and early treatment. Current clinical risk models for the prediction of cardiac surgery-associated AKI are insufficient, particularly in patients with preexisting kidney dysfunction. Methods: To identify intraoperative variables that might improve the performance of a validated clinical risk score (Cleveland Clinic Score, CCS) for the prediction of cardiac surgery-associated AKI, we conducted a prospective cohort study in 289 consecutive elective cardiac surgery patients at a tertiary care center...
March 2017: KI Reports
https://www.readbyqxmd.com/read/29142953/absence-of-hiv-associated-nephropathy-among-antiretroviral-naive-adults-with-persistent-albuminuria-in-western-kenya
#13
M K Koech, M O G Owiti, W D Owino-Ong'or, A K Koskei, M J Karoney, V D D'Agati, C M Wyatt
Introduction: HIV-associated nephropathy (HIVAN) has been strongly linked to African ancestry. However, studies have demonstrated wide variability in the prevalence of HIVAN in different sub-Saharan African populations. Accurate assessment of the disease burden is important because antiretroviral therapy (ART) is increasingly available and may prevent progression to end-stage renal disease. Methods: We prospectively screened ART-naïve, afebrile, nonhypertensive, and nondiabetic adults attending a large HIV care program in Western Kenya for the presence of albuminuria (dipstick albumin ≥ trace or urine albumin to creatinine ratio [UACR] ≥ 30 mg/g)...
March 2017: KI Reports
https://www.readbyqxmd.com/read/29142798/verification-of-diagnosis-in-tuberculosis-a-case-report-and-discussion
#14
Amanda M Dave, Abed Adelrahman, Vishist Mehta, Stephen Cavalieri, Renuga Vivekanadan
Tuberculosis (TB), caused by strains of Mycobacterium tuberculosis complex (M. tuberculosis), is a pulmonary infection that is spread by airborne droplet transmission. The development and spread of drug-resistant strains of M. tuberculosisgreatly jeopardize TB control efforts. We report the case of a previously healthy 43-year-old male, visiting from China, who presented to the emergency department complaining of hemoptysis of 10 days' duration. Cultures were positive for acid fast bacteria and negative for fungi...
September 3, 2017: Curēus
https://www.readbyqxmd.com/read/29142744/-who-has-to-do-it-at-the-end-of-the-day-programme-officials-or-hospital-authorities-airborne-infection-control-at-drug-resistant-tuberculosis-dr-tb-centres-of-karnataka-india-a-mixed-methods-study
#15
Kibballi Madhukeshwar Akshaya, Hemant Deepak Shewade, Ottapura Prabhakaran Aslesh, Sharath Burugina Nagaraja, Abhay Subashrao Nirgude, Anil Singarajipura, Anil G Jacob
Background: Drug resistant tuberculosis (DR-TB) centers admit patients with DR-TB for initiation of treatment and thereby concentrate the patients under one setting. It becomes imperative to assess the compliance of DR-TB centres to national airborne infection control (AIC) guidelines and explore the provider perspectives into reasons for unsatisfactory compliance. Methods: This mixed methods study (triangulation design) was carried out across all the six DR-TB centers of Karnataka state, India, between November 2016 and April 2017...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/29142631/mortality-and-epidemiology-in-256-cases-of-pediatric-traumatic-brain-injury-korean-neuro-trauma-data-bank-system-kntdbs-2010-2014
#16
Hee-Won Jeong, Seung-Won Choi, Jin-Young Youm, Jeong-Wook Lim, Hyon-Jo Kwon, Shi-Hun Song
Objective: Among pediatric injury, brain injury is a leading cause of death and disability. To improve outcomes, many developed countries built neurotrauma databank (NTDB) system but there was not established nationwide coverage NTDB until 2009 and there have been few studies on pediatric traumatic head injury (THI) patients in Korea. Therefore, we analyzed epidemiology and outcome from the big data of pediatric THI. Methods: We collected data on pediatric patients from 23 university hospitals including 9 regional trauma centers from 2010 to 2014 and analyzed their clinical factors (sex, age, initial Glasgow coma scale, cause and mechanism of head injury, presence of surgery)...
November 2017: Journal of Korean Neurosurgical Society
https://www.readbyqxmd.com/read/29142478/chronic-opioids-in-gastroparesis-relationship-with-gastrointestinal-symptoms-healthcare-utilization-and-employment
#17
Asad Jehangir, Henry P Parkman
AIM: To examine the relationship of chronic scheduled opioid use on symptoms, healthcare utilization and employment in gastroparesis (Gp) patients. METHODS: Patients referred to our tertiary care academic center from May 2016 to July 2017, with established diagnosis or symptoms suggestive of Gp filled out the Patient Assessment of Upper GI Symptoms, abdominal pain and demographics questionnaires, and underwent gastric emptying and blood tests. They were asked about taking pain medicines and the types, doses, and duration...
October 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29142474/clinical-features-of-alcoholic-hepatitis-in-latinos-and-caucasians-a-single-center-experience
#18
Rogelio Pinon-Gutierrez, Blythe Durbin-Johnson, Charles H Halsted, Valentina Medici
AIM: To study differences of presentation, management, and prognosis of alcoholic hepatitis in Latinos compared to Caucasians. METHODS: We retrospectively screened 876 charts of Caucasian and Latino patients who were evaluated at University of California Davis Medical Center between 1/1/2002-12/31/2014 with the diagnosis of alcoholic liver disease. We identified and collected data on 137 Caucasians and 64 Latinos who met criteria for alcoholic hepatitis, including chronic history of heavy alcohol use, at least one episode of jaundice with bilirubin ≥ 3...
October 28, 2017: World Journal of Gastroenterology: WJG
https://www.readbyqxmd.com/read/29142380/epidemiological-study-of-patients-of-road-traffic-injuries-attending-emergency-department-of-a-trauma-center-in-new-delhi
#19
Puneet Misra, Anindo Majumdar, Mahesh Chandra Misra, Shashi Kant, Sanjeev Kumar Gupta, Amit Gupta, Subodh Kumar
Background and Aims: There is paucity of data regarding some of the lesser known contextual and epidemiological factors with respect to road traffic injuries (RTIs). The objective was to study the epidemiological profile of RTI victims attending an emergency department of a tertiary care trauma center. Methods: The present study was a hospital-based cross-sectional study conducted in the emergency department of a tertiary care trauma center in New Delhi. All patients of RTI attending the emergency department during the designated data collection days were included in the study...
October 2017: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29142375/the-effects-of-atorvastatin-on-inflammatory-responses-and-mortality-in-septic-shock-a-single-center-randomized-controlled-trial
#20
Ratender Kumar Singh, Vikas Agarwal, Arvind Kumar Baronia, Sudeep Kumar, Banani Poddar, Afzal Azim
Aim of the Study: Pleiotropic effect of statins can modulate inflammation in septic shock. We tested the hypothesis whether statins can reduce mortality in septic shock. Patients and Methods: We conducted a randomized double-blinded trial with treatment (40 mg dose of atorvastatin for 7 days) and control (placebo) arm in adult septic shock patients admitted to the Intensive Care Unit. Primary (28-day mortality) and secondary (vasopressor-, ventilation-, and renal replacement therapy-free days) outcomes, with lipid profile and adverse effects, were documented...
October 2017: Indian Journal of Critical Care Medicine
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