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https://www.readbyqxmd.com/read/28445873/pregnancy-outcomes-in-patients-with-glomerular-disease-attending-a-single-academic-center-in-north-carolina
#1
Michelle M O'Shaughnessy, Meghan A Jobson, Katy Sims, Abigail L Liberty, Patrick H Nachman, William F Pendergraft
BACKGROUND: Contemporary data regarding pregnancy outcomes in US patients with primary glomerular diseases are lacking. We aimed to report fetal and maternal outcomes among women with biopsy-proven primary glomerular disease who received obstetric care at a single large academic US center. METHODS: All women with a biopsy-confirmed primary glomerular disease diagnosis and without end-stage kidney disease who received obstetric care at the University of North Carolina (UNC) Hospitals (1996-2015) were identified using the Glomerular Disease Collaborative Network registry and the UNC Hospitals Perinatal Database...
April 27, 2017: American Journal of Nephrology
https://www.readbyqxmd.com/read/28445859/a-risk-scoring-model-based-on-vital-signs-and-laboratory-data-predicting-transfer-to-the-intensive-care-unit-of-patients-admitted-to-gastroenterology-wards
#2
Won-Young Kim, Jinmi Lee, Ju-Ry Lee, Youn Kyung Jung, Hwa Jung Kim, Jin Won Huh, Chae-Man Lim, Younsuck Koh, Sang-Bum Hong
PURPOSE: To compare the ability of a score based on vital signs and laboratory data with that of the modified early warning score (MEWS) to predict ICU transfer of patients with gastrointestinal disorders. MATERIALS AND METHODS: Consecutive events triggering medical emergency team activation in adult patients admitted to the gastroenterology wards of the Asan Medical Center were reviewed. Binary logistic regression was used to identify factors predicting transfer to the ICU...
April 19, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28445858/the-impact-of-minor-blood-transfusion-on-the-outcome-after-coronary-artery-bypass-grafting
#3
Eeva-Maija Kinnunen, Marco Zanobini, Francesco Onorati, Debora Brascia, Giovanni Mariscalco, Ilaria Franzese, Vito G Ruggieri, Karl Bounader, Andrea Perrotti, Francesco Musumeci, Giuseppe Santarpino, Daniele Maselli, Saverio Nardella, Helmut Gulbins, Riccardo Gherli, Antonino S Rubino, Carmelo Mignosa, Marisa De Feo, Giuseppe Gatti, Francesco Santini, Antonio Salsano, Magnus Dalén, Matteo Saccocci, Daniel Reichart, Giuseppe Faggian, Tiziano Gherli, Francesco Nicolini, Fausto Biancari
PURPOSE: To investigate the impact of minor perioperative bleeding requiring transfusion of 1-2 red blood cell (RBC) units on the outcome after coronary artery bypass grafting (CABG). METHODS: Sixteen cardiac surgical centers contributed to the prospective European CABG registry (E-CABG). 1014 patients receiving 1-2 RBC units during or after isolated CABG were compared to 2264 patients not receiving RBCs. RESULTS: In 827 propensity score matched pairs, transfusion of 1-2 RBC units did not affect the risk of in-hospital/30-day death (p=0...
April 19, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28445796/decreasing-the-use-of-damage-control-laparotomy-in-trauma-a-quality-improvement-project
#4
John A Harvin, Lillian S Kao, Mike K Liang, Sasha D Adams, Michelle K McNutt, Joseph D Love, Laura J Moore, Charles E Wade, Bryan A Cotton, John B Holcomb
BACKGROUND: Our institution has published damage control laparotomy (DCL) rates of 30% and documented the substantial morbidity associated with the open abdomen. The purpose of this quality improvement (QI) project was to decrease the rate of DCL at a busy, Level 1 trauma center in the United States. STUDY DESIGN: A prospective cohort of all emergent trauma laparotomies from 11/2013-10/2015 (QI group) were followed. The QI intervention was multi-faceted and included audit and feedback for every DCL case...
April 23, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/28445790/improving-insomnia-in-primary-care-patients-a-randomized-controlled-trial-of-nurse-led-group-treatment
#5
Christina Sandlund, Jerker Hetta, Gunnar H Nilsson, Mirjam Ekstedt, Jeanette Westman
BACKGROUND: Insomnia is a common health problem, and most people who seek help for insomnia consult primary care. In primary care, insomnia treatment typically consists of hypnotic drugs, although cognitive behavioral therapy for insomnia is the recommended treatment. However, such treatment is currently available to few primary care patients. OBJECTIVES: To evaluate the effects of a group treatment program for insomnia led by nurses in primary care. OUTCOMES: were the Insomnia Severity Index, a 2-week sleep diary, and a questionnaire on frequency of hypnotic drug use...
April 14, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28445566/variation-in-outcomes-at-bariatric-surgery-centers-of-excellence
#6
Andrew M Ibrahim, Amir A Ghaferi, Jyothi R Thumma, Justin B Dimick
Importance: In the United States, reports about perioperative complications associated with bariatric surgery led to the establishment of accreditation criteria for bariatric centers of excellence and many bariatric centers obtaining accreditation. Currently, most bariatric procedures occur at these centers, but to what extent they uniformly provide high-quality care remains unknown. Objective: To describe the variation in surgical outcomes across bariatric centers of excellence and the geographic availability of high-quality centers...
April 26, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28445559/association-of-us-centers-for-medicare-and-medicaid-services-hospital-30-day-risk-standardized-readmission-metric-with-care-quality-and-outcomes-after-acute-myocardial-infarction-findings-from-the-national-cardiovascular-data-registry-acute-coronary-treatment
#7
Ambarish Pandey, Harsh Golwala, Hurst M Hall, Tracy Y Wang, Di Lu, Ying Xian, Karen Chiswell, Karen E Joynt, Abhinav Goyal, Sandeep R Das, Dharam Kumbhani, Howard Julien, Gregg C Fonarow, James A de Lemos
Importance: The US Centers for Medicare and Medicaid Services Hospital Readmissions Reduction Program penalizes hospitals with higher-than-expected risk-adjusted 30-day readmission rates (excess readmission ratio [ERR] > 1) after acute myocardial infarction (MI). However, the association of ERR with MI care processes and outcomes are not well established. Objective: To evaluate the association between ERR for MI with in-hospital process of care measures and 1-year clinical outcomes...
April 26, 2017: JAMA Cardiology
https://www.readbyqxmd.com/read/28445437/an-exploratory-study-on-the-influence-of-psychopathological-risk-and-impulsivity-on-bmi-and-perceived-quality-of-life-in-obese-patients
#8
Renata Tambelli, Luca Cerniglia, Silvia Cimino, Giulia Ballarotto, Marinella Paciello, Carla Lubrano, Serena Marchitelli, Lucio Gnessi, Andrea Lenzi
The present study aimed to assess the psychological profiles of adult male and female obese patients, as well as to verify the possible influence of their psychopathological risk and impulsivity on their body mass index (BMI) and perceived quality of life. A total of 64 obese subjects accessing a center for care of their obesity were assessed through anthropometric and psychometric measurements. All anthropometric measures in men were higher than in women, while in turn, women showed higher psychopathological symptoms...
April 26, 2017: Nutrients
https://www.readbyqxmd.com/read/28445418/hyponatremia-is-associated-with-worse-outcomes-from-fall-injuries-in-the-elderly
#9
Spencer C H Kuo, Pao-Jen Kuo, Cheng-Shyuan Rau, Shao-Chun Wu, Shiun-Yuan Hsu, Ching-Hua Hsieh
Background: Hyponatremia has been proposed as a contributor to falls in the elderly, which have become a major global issue with the aging of the population. This study aimed to assess the clinical presentation and outcomes of elderly patients with hyponatremia admitted due to fall injuries in a Level I trauma center. Methods: We retrospectively reviewed data obtained from the Trauma Registry System for trauma admissions from January 2009 through December 2014. Hyponatremia was defined as a serum sodium level <135 mEq/L, and only patients who had sustained a fall at ground level (<1 m) were included...
April 26, 2017: International Journal of Environmental Research and Public Health
https://www.readbyqxmd.com/read/28445240/evaluation-of-a-pediatric-early-warning-score-across-different-subspecialty-patients
#10
Nathan P Dean, J B Fenix, Michael Spaeder, Amanda Levin
OBJECTIVE: To evaluate the ability of a Pediatric Early Warning Score to predict deterioration in different subspecialty patient populations. DESIGN: Single center, retrospective cohort study. Patients were classified into five groups: 1) cardiac; 2) hematology/oncology/bone marrow transplant; 3) surgical; 4) neurologic; and 5) general medical. The relationship between the Pediatric Early Warning Score and unplanned ICU transfer requiring initiation of specific ICU therapies (intubation, high-flow nasal cannula, noninvasive ventilation, inotropes, or aggressive fluid hydration within 12 hr of transfer) was evaluated...
April 25, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28445100/remap-a-framework-for-goals-of-care-conversations
#11
Julie W Childers, Anthony L Back, James A Tulsky, Robert M Arnold
Conversations regarding goals of care with patients who have advanced cancer still occur too late, and oncologists say they lack the training to have these conversations effectively. Experts recommend a number of strategies when having these discussions, including discussing prognosis, responding to patient emotion, exploring values, and often making a recommendation for medical treatments that fit those values. To help learners, from residents to attending oncologists, learn these complex conversational skills, we have developed a framework with a mnemonic, REMAP: Reframe, Expect emotion, Map out patient goals, Align with goals, and Propose a plan...
April 26, 2017: Journal of Oncology Practice
https://www.readbyqxmd.com/read/28445012/drug-resistance-patterns-of-multidrug-and-extensively-drug-resistant-tuberculosis-in-korea-amplification-of-resistance-to-oral-second-line-drugs
#12
Chang Ki Kim, So Youn Shin, Hee Jin Kim, Kyungwon Lee
We aimed to analyze the drug resistance patterns of multidrug-resistant and extensively drug-resistant tuberculosis (TB) and the difference of drug resistance among various settings for health care in Korea. The data of drug susceptibility testing in 2009 was analyzed in order to secure sufficient number of patients from various settings in Korea. Patients were categorized by types of institutions into four groups, which comprised new and previously treated patients from public health care centers (PHC), the private sector, and Double-barred Cross clinics (DBC)...
July 2017: Annals of Laboratory Medicine
https://www.readbyqxmd.com/read/28444697/population-pharmacokinetics-of-dexmedetomidine-in-infants
#13
Rachel G Greenberg, Huali Wu, Matthew Laughon, Edmund Capparelli, Stevie Rowe, Kanecia O Zimmerman, P Brian Smith, Michael Cohen-Wolkowiez
Despite limited pharmacokinetic (PK) data, dexmedetomidine is increasingly being used off-label for sedation in infants. We aimed to characterize the developmental PK changes of dexmedetomidine during infancy. In this open-label, single-center PK study of dexmedetomidine in infants receiving dexmedetomidine per clinical care, ≤10 blood samples per infant were collected. A set of structural PK models and residual error models were explored using nonlinear mixed-effects modeling in NONMEM. Covariates including postmenstrual age (PMA), serum creatinine, and recent history of cardiac surgery requiring cardiopulmonary bypass were investigated for their influence on PK parameters...
April 25, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/28444642/breast-self-exam-and-patient-interval-associate-with-advanced-breast-cancer-and-treatment-delay-in-mexican-women
#14
E Leon-Rodriguez, C Molina-Calzada, M M Rivera-Franco, A Campos-Castro
PURPOSE: The objective of this study was to compare treatment intervals in breast cancer patients according to the detection method (breast self-exam vs screening). PATIENTS AND METHODS: We conducted a retrospective analysis including 291 breast cancer patients at a Mexican tertiary referral hospital. RESULTS: Breast cancer detection method was mostly breast self-exam (60%). The median patient interval was 60.5 days, and was associated with marital status and socioeconomic level...
April 25, 2017: Clinical & Translational Oncology
https://www.readbyqxmd.com/read/28444574/a-randomized-controlled-trial-of-the-effectiveness-of-a-psychoeducational-intervention-on-family-caregivers-of-patients-with-mental-disorders
#15
Viviane Tabeleão, Elaine Tomasi, Luciana de Avila Quevedo
The present study aimed to investigate the effectiveness of a psychoeducational intervention on caregivers of patients assisted by the Center for Psychosocial Health Care (CPHC) focusing on the patient's psychopathology. This was a randomized clinical trial with 130 caregivers with higher mean burden scores assessed using the Zarit Burden Interview Scale (ZBI) (66 caregivers in the intervention group and 64 in the control group). The intervention included six home visits of psychoeducational interventions according to each mental disorder identified in the CPHC records...
April 25, 2017: Community Mental Health Journal
https://www.readbyqxmd.com/read/28444489/biodegradable-stents-for-caustic-esophageal-strictures-do-they-work
#16
Rakesh Kochhar, Jayanta Samanta, Jahangeer Basha, Abhai Verma, Gourdas Choudhuri, Sundeep Lakhtakia, D Nageshwar Reddy
Biodegradable (BD) stents have been used for the management of various esophageal strictures (ES) but the experience of its use in caustic strictures is limited. The present study, aimed at evaluating efficacy of BD stents for the treatment of refractory caustic-induced ES, was a retrospective multi-center study conducted at three tertiary care centers in India wherein adult patients with refractory caustic induced strictures underwent placement of a BD stent. Patients were followed up for immediate complications and long term outcome...
April 25, 2017: Dysphagia
https://www.readbyqxmd.com/read/28444069/predictors-and-pattern-of-weaning-and-long-term-outcome-of-patients-with-prolonged-mechanical-ventilation-at-an-acute-intensive-care-unit-in-north-india
#17
Syed Nabeel Muzaffar, Mohan Gurjar, Arvind K Baronia, Afzal Azim, Prabhakar Mishra, Banani Poddar, Ratender K Singh
Objective: This study aimed to examine the clinical characteristics, weaning pattern, and outcome of patients requiring prolonged mechanical ventilation in acute intensive care unit settings in a resource-limited country. Methods: This was a prospective single-center observational study in India, where all adult patients requiring prolonged ventilation were followed for weaning duration and pattern and for survival at both intensive care unit discharge and at 12 months...
January 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28443699/the-experiences-of-parents-of-pediatric-patients-with-acute-lymphoblastic-leukemia-2-months-after-completion-of-treatment
#18
Barbara Muskat, Heather Jones, Sonia Lucchetta, Wendy Shama, Sue Zupanec, Andrea Greenblatt
Diagnosis and treatment of childhood acute lymphoblastic leukemia (ALL) can be a highly stressful time for the entire family. While completion of treatment may bring relief to some families, it may also bring about additional anxieties and fear. The primary objective of this article is to present an analysis of the experiences, emotional states, and support needs of parents of pediatric cancer patients 2 months after treatment completion for ALL. Using a qualitative interpretive description approach, transcripts from interviews with 17 parents from the leukemia/lymphoma program of a large urban pediatric cancer center were analyzed using N-Vivo 10 data analysis software...
April 1, 2017: Journal of Pediatric Oncology Nursing: Official Journal of the Association of Pediatric Oncology Nurses
https://www.readbyqxmd.com/read/28443678/outcomes-along-the-hiv-care-continuum-among-undocumented-immigrants-in-clinical-care
#19
Jonathan Ross, Uriel R Felsen, Chinazo O Cunningham, Viraj V Patel, David B Hanna
HIV-infected undocumented immigrants face unique barriers to care yet little is known about their clinical outcomes. We performed a retrospective cohort study of HIV-infected adults in clinical care from 2006-2014 at a large academic medical center in a setting where medical insurance is available to HIV-infected undocumented immigrants. Undocumented status was assessed based on Social Security number and insurance status and verified through medical chart review. Using Poisson regression models, we compared undocumented and documented patients with respect to retention in care (≥ 2 HIV-related lab tests ≥ 90 days apart), antiretroviral therapy (ART) prescription (≥ 3 active antiretroviral agents prescribed in a year) and viral suppression (HIV RNA <200 copies/ml for the last measured viral load) for each year in care...
April 26, 2017: AIDS Research and Human Retroviruses
https://www.readbyqxmd.com/read/28443589/significance-of-inverted-pattern-in-non-invasive-low-grade-papillary-urothelial-carcinoma-of-bladder
#20
Sehbal Arslankoz, İbrahim Kulaç, Dilek Ertoy Baydar
AIMS: The purpose of this study is to evaluate the impact of histological inverted pattern on recurrence in patients with newly diagnosed non-invasive low-grade papillary urothelial carcinoma of the urinary bladder. METHODS: A total of 81 patients with primary bladder non-invasive low-grade papillary urothelial carcinomadiagnosed in a single tertiary care center between 2000 and 2011 who had at least 1 year follow-up after an initial resection were included. All slides from each case were reviewed to determine the growth pattern (exophytic versus endophytic, i...
April 13, 2017: Balkan Medical Journal
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