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https://www.readbyqxmd.com/read/29044463/prehospital-delay-in-older-adults-with-acute-myocardial-infarction-the-comprehensive-evaluation-of-risk-factors-in-older-patients-with-acute-myocardial-infarction-study
#1
Gregory M Ouellet, Mary Geda, Terrence E Murphy, Sui Tsang, Mary E Tinetti, Sarwat I Chaudhry
BACKGROUND/OBJECTIVES: Timely administration of antiischemic therapies improves outcomes in individuals with acute myocardial infarction (AMI). Prior literature on delays in AMI care has largely focused on in-hospital delay ("door to balloon" time). Our objective was to identify factors associated with prehospital delay in a contemporary national cohort of older adults with AMI. DESIGN: Cross-sectional analysis of data from the ComprehenSIVe Evaluation of Risk Factors in Older Patients with Acute Myocardial Infarction (SILVER-AMI) study, an observational study of older adults hospitalized for AMI...
October 18, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29044457/secondary-prevention-medication-use-after-myocardial-infarction-in-u-s-nursing-home-residents
#2
Andrew R Zullo, Sadia Sharmin, Yoojin Lee, Lori A Daiello, Nishant R Shah, W John Boscardin, David D Dore, Sei J Lee, Michael A Steinman
BACKGROUND/OBJECTIVES: Secondary prevention medications are recommended for older adults after acute myocardial infarction (AMI), but little is known about whether nursing home (NH) residents receive these medications. The objective was to evaluate new use of secondary prevention medications after AMI in NH residents who were previously nonusers and to evaluate what factors were associated with use. DESIGN: Retrospective cohort using linked national Minimum Data Set assessments; Online Survey, Certification and Reporting records; and Medicare claims...
October 17, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29043079/acute-coronary-syndromes-in-the-elderly
#3
REVIEW
Niels Engberding, Nanette K Wenger
The clinical evidence for treatment of acute coronary syndrome (ACS) in the elderly is less robust than in patients younger than 75 years. The elderly have the highest incidence of cardiovascular disease and frequently present with ACS. This number can be expected to increase over time because society is aging. Older adults often sustain unfavorable outcomes from ACS because of atypical presentation and delay in recognition. In addition, elderly patients commonly do not receive optimal guideline-directed ACS treatment...
2017: F1000Research
https://www.readbyqxmd.com/read/29042825/antithrombotics-in-trauma-management-strategies-in-the-older-patients
#4
REVIEW
Henna Wong, Nicola Lovett, Nicola Curry, Ku Shah, Simon J Stanworth
The ageing population has resulted in a change in the demographics of trauma, and older adult trauma now accounts for a growing number of trauma admissions. The management of older adult trauma can be particularly challenging, and exhibits differences to that of the younger age groups affected by trauma. Frailty syndromes are closely related with falls, which are the leading cause of major trauma in older adults. Comorbid disease and antithrombotic use are more common in the older population. Physiological changes that occur with ageing can alter the expected clinical presentation of older persons after injury and their susceptibility to injury...
2017: Journal of Blood Medicine
https://www.readbyqxmd.com/read/29038870/chiropractic-care-and-risk-for-acute-lumbar-disc-herniation-a-population-based-self-controlled-case-series-study
#5
Cesar A Hincapié, George A Tomlinson, Pierre Côté, Y Raja Rampersaud, Alejandro R Jadad, J David Cassidy
PURPOSE: Chiropractic care is popular for low back pain, but may increase the risk for acute lumbar disc herniation (LDH). Low back pain is a common early (prodromal) symptom of LDH and commonly precedes LDH diagnosis. Our objective was to investigate the association between chiropractic care and acute LDH with early surgical intervention, and contrast this with the association between primary care physician (PCP) care and acute LDH with early surgery. METHODS: Using a self-controlled case series design and population-based healthcare databases in Ontario, Canada, we investigated all adults with acute LDH requiring emergency department (ED) visit and early surgical intervention from April 1994 to December 2004...
October 16, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29038868/the-global-spine-care-initiative-a-review-of-reviews-and-recommendations-for-the-non-invasive-management-of-acute-osteoporotic-vertebral-compression-fracture-pain-in-low-and-middle-income-communities
#6
REVIEW
Arthur Ameis, Kristi Randhawa, Hainan Yu, Pierre Côté, Scott Haldeman, Roger Chou, Eric L Hurwitz, Margareta Nordin, Jessica J Wong, Heather M Shearer, Anne Taylor-Vaisey
PURPOSE: The purpose of this review was to develop recommendations for non-invasive management of pain due to osteoporotic vertebral compression fractures (OVCF) that could be applied in medically underserved areas and low- and middle-income countries. METHODS: We conducted a systematic review and best evidence synthesis of systematic reviews on the non-invasive management of OVCF. Eligible reviews were critically appraised using the Scottish Intercollegiate Guidelines Network criteria...
October 16, 2017: European Spine Journal
https://www.readbyqxmd.com/read/29038045/effects-of-procalcitonin-guided-treatment-on-antibiotic-use-and-need-for-mechanical-ventilation-in-patients-with-acute-asthma-exacerbation-meta-analysis-of-randomized-controlled-trials
#7
Wanis H Ibrahim, Kamran Mushtaq, Tasleem Raza, Anand Kartha, Ahmed O Saleh, Rayaz A Malik
OBJECTIVE: The primary outcome was to determine whether serum procalcitonin-guided antibiotic therapy can reduce antibiotic exposure in patients with an acute exacerbation of asthma presenting to the primary care facility, emergency department or during hospital admission. The secondary outcome was the need for mechanical ventilation. METHODS: In this meta-analysis, we performed extensive literature search for randomized controlled clinical trials (published in English) that compared serum procalcitonin-guided antibiotic therapy versus antibiotic use according to physician's discretion for adult participants with mild, moderate or severe acute asthma exacerbations...
October 13, 2017: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/29037528/driving-pressure-and-hospital-mortality-in-patients-without-ards-a-cohort-study
#8
Marcello F S Schmidt, Andre C K B Amaral, Eddy Fan, Gordon D Rubenfeld
BACKGROUND: Driving pressure is associated with mortality in patients with Acute Respiratory Distress Syndrome (ARDS) and with pulmonary complications in patients undergoing general anesthesia. Whether driving pressure is associated with outcomes of patients without ARDS ventilated in the intensive care unit is unknown. Our objective was to determine the independent association between driving pressure and outcomes in mechanically ventilated patients without ARDS on day 1 of mechanical ventilation...
October 13, 2017: Chest
https://www.readbyqxmd.com/read/29033616/nationwide-trends-of-clinical-characteristics-and-economic-burden-of-emergency-department-visits-due-to-acute-ischemic-stroke
#9
Mark Stuntz, Katsiaryna Busko, Shumaila Irshad, Taylor Paige, Veranika Razhkova, Tim Coan
We aimed to provide estimates of the volume and associated charges of acute ischemic stroke (AIS) visits in the US, as well as to assess predictors of patient disposition following an emergency department (ED) visit for AIS. Our study was conducted using the 2010-2013 data from the Nationwide Emergency Department Sample. We identified adult visits with AIS as the primary diagnosis. A generalized linear model was used to calculate mean charges per visit after adjusting for covariates. Multinomial logistic regression was used to assess predictors of patient disposition following an ED visit for AIS...
2017: Open Access Emergency Medicine: OAEM
https://www.readbyqxmd.com/read/29033294/acetaminophen-or-nonsteroidal-anti-inflammatory-drugs-in-acute-musculoskeletal-trauma-a%C3%A2-multicenter-double-blind-randomized-clinical-trial
#10
Milan L Ridderikhof, Philipp Lirk, Helma Goddijn, Edwin Vandewalle, Erik Schinkel, Susan Van Dieren, E Marleen Kemper, Markus W Hollmann, J Carel Goslings
STUDY OBJECTIVE: We determine whether pain treatment with acetaminophen was not inferior to nonsteroidal anti-inflammatory drugs or the combination of both in minor musculoskeletal trauma. METHODS: The Paracetamol or NSAIDs in Acute Musculoskeletal Trauma Study was a double-blind, randomized, clinical trial conducted in 2 general practices and 2 emergency departments in the Netherlands. A total of 547 adults, aged 18 years and older, with acute blunt minor musculoskeletal extremity trauma were randomly assigned in a 1:1:1 ratio to acetaminophen 4,000 mg/day, diclofenac 150 mg/day, or acetaminophen 4,000 mg/day+diclofenac 150 mg/day during 3 consecutive days...
October 13, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29032898/estimating-influenza-vaccine-effectiveness-evolution-of-methods-to-better-understand-effects-of-confounding-in-older-adults
#11
REVIEW
Janet E McElhaney, Melissa K Andrew, Shelly A McNeil
Older adults are at high risk for serious complications of influenza illness and loss of vaccine-mediated protection. It is increasingly recognized that in addition to age, multiple chronic conditions and associated frailty contribute to the decline in vaccine effectiveness in this population. However, observational studies have been fraught with issues of confounding related to the degree of frailty and functional decline, measures of which are not included in standard administrative health care databases that are used to calculate vaccine effectiveness...
November 1, 2017: Vaccine
https://www.readbyqxmd.com/read/29031347/rehabilitation-needs-of-the-elder-with-traumatic-brain-injury
#12
REVIEW
Manuel F Mas, Amy Mathews, Ekua Gilbert-Baffoe
The incidence of traumatic brain injury (TBI) in older adults is increasing. As the expected life expectancy increases, there is a heightened need for comprehensive rehabilitation for this population. Elderly patients with TBI benefit from rehabilitation interventions at all stages of injury and can achieve functional gains during acute inpatient rehabilitation. Clinicians should be vigilant of unique characteristics of this population during inpatient rehabilitation, including vulnerability to polypharmacy, posttraumatic hydrocephalus, neuropsychiatric sequelae, sleep disturbances, and sensory deficits...
November 2017: Physical Medicine and Rehabilitation Clinics of North America
https://www.readbyqxmd.com/read/29031316/identifying-the-unmet-supportive-care-needs-with-concomitant-influencing-factors-in-adult-acute-leukemia-patients-in-china
#13
Fang-Fang Yu, Yan-Ni Bai, Hua He, Li Zhu, Rui-Li Zhang, Hong-Xia Jiao, Qiao-Yan Li, Ju-Fang Fu
PURPOSE: To understand the supportive care needs (SCNs), with associated influencing factors, related to five unmet need dimensions in adult Acute Leukemia (AL) patients, in China. METHODS: This multi-center cross-sectional study enrolled 340 pathologically confirmed adult, Chinese AL patients who were requested to complete a self-reported questionnaire, detailing demographic information, general status and physical functions, and Supportive Care Needs Survey-Short Form 34 (SCNS-SF34), revealing their unmet SCNs...
October 2017: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
https://www.readbyqxmd.com/read/29028659/differences-in-acute-retroviral-syndrome-by-hiv-1-subtype-in-a-multicentre-cohort-study-in-africa
#14
Eduard J Sanders, Matthew A Price, Etienne Karita, Anatoli Kamali, William Kilembe, Linda-Gail Bekker, Shabir Lakhi, Mubiana Inambao, Omu Anzala, Patricia E Fast, Jill Gilmour, Kimberly A Powers
BACKGROUND: Symptoms of acute retroviral syndrome (ARS) may be used to identify patients with acute HIV-1 infection who seek care. ARS symptoms in African adults differ by region. We assessed whether reporting of ARS was associated with HIV-1 subtype in a multicentre African cohort study representing countries with predominant HIV-1 subtypes A, C and D. METHODOLOGY: ARS symptoms were assessed in adults enrolling ≤6 weeks after the estimated date of infection (EDI) in an acute and early HIV-1 infection cohort study...
October 12, 2017: AIDS
https://www.readbyqxmd.com/read/29027656/pulmonary-complications-after-non-cardiac-surgeries-temporal-patterns-and-risk-factors
#15
Cássia Toledo, Flávio Eduardo Nácul, Marcos Freitas Knibel, Nilton Brandão Silva, Ederlon Rezende, Cintia Magalhães Carvalho Grion, Murillo Assunção, Fernando Gutierrez, Joelma Villafanha Gandolfi, Suzana Margareth Lobo
BACKGROUND: Postoperative complications are the primary determinants of survival following major surgery. We aimed to characterize the early perioperative risk factors for postoperative pulmonary complications (POPCs) in patients undergoing major non-cardiac surgeries. METHODS: This study utilized a multicenter prospective observational cohort design. Adult patients undergoing non-cardiac surgeries and admitted to 21 Brazilian ICUs were screened for inclusion in the study...
October 13, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/29025194/procalcitonin-to-initiate-or-discontinue-antibiotics-in-acute-respiratory-tract-infections
#16
REVIEW
Philipp Schuetz, Yannick Wirz, Ramon Sager, Mirjam Christ-Crain, Daiana Stolz, Michael Tamm, Lila Bouadma, Charles E Luyt, Michel Wolff, Jean Chastre, Florence Tubach, Kristina B Kristoffersen, Olaf Burkhardt, Tobias Welte, Stefan Schroeder, Vandack Nobre, Long Wei, Heiner C Bucher, Neera Bhatnagar, Djillali Annane, Konrad Reinhart, Angela Branche, Pierre Damas, Maarten Nijsten, Dylan W de Lange, Rodrigo O Deliberato, Stella Ss Lima, Vera Maravić-Stojković, Alessia Verduri, Bin Cao, Yahya Shehabi, Albertus Beishuizen, Jens-Ulrik S Jensen, Caspar Corti, Jos A Van Oers, Ann R Falsey, Evelien de Jong, Carolina F Oliveira, Bianca Beghe, Matthias Briel, Beat Mueller
BACKGROUND: Acute respiratory infections (ARIs) comprise of a large and heterogeneous group of infections including bacterial, viral, and other aetiologies. In recent years, procalcitonin (PCT), a blood marker for bacterial infections, has emerged as a promising tool to improve decisions about antibiotic therapy (PCT-guided antibiotic therapy). Several randomised controlled trials (RCTs) have demonstrated the feasibility of using procalcitonin for starting and stopping antibiotics in different patient populations with ARIs and different settings ranging from primary care settings to emergency departments, hospital wards, and intensive care units...
October 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29025142/community-acquired-acute-kidney-injury-findings-from-a-large-population-cohort
#17
J Holmes, J Geen, B Phillips, J D Williams, A O Phillips
Background: The extent of patient contact with medical services prior to development of community acquired-acute kidney injury (CA-AKI)is unknown. Aim: We examined the relationship between incident CA-AKI alerts, previous contact with hospital or primary care and clinical outcomes. Design: A prospective national cohort study of all electronic AKIalerts representing adult CA-AKI. Methods: Data were collected for all cases of adult (≥18 years of age) CA-AKI in Wales between 1 November 2013 and 31 January 2017...
July 21, 2017: QJM: Monthly Journal of the Association of Physicians
https://www.readbyqxmd.com/read/29025049/senior-services-in-us-hospitals-and-readmission-risk-in-the-medicare-population
#18
Alicia I Arbaje, Qilu Yu, Jiangxia Wang, Bruce Leff
Background: There is a little understanding of the association between hospital organizational characteristics and hospital readmissions. We previously developed a Senior Care Services Scale (SCSS) that describes hospital availability of services relevant to the care of older adults. Objective: Determine whether hospitals' SCSS scores were associated with risk of readmission among Medicare beneficiaries. Design: Retrospective cohort analysis...
September 13, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/29023260/dysphagia-in-mechanically-ventilated-icu-patients-dynamics-a-prospective-observational-trial
#19
Joerg C Schefold, David Berger, Patrick Zürcher, Michael Lensch, Andrea Perren, Stephan M Jakob, Ilkka Parviainen, Jukka Takala
OBJECTIVES: Swallowing disorders may be associated with adverse clinical outcomes in patients following invasive mechanical ventilation. We investigated the incidence of dysphagia, its time course, and association with clinically relevant outcomes in extubated critically ill patients. DESIGN: Prospective observational trial with systematic dysphagia screening and follow-up until 90 days or death. SETTINGS: ICU of a tertiary care academic center...
October 11, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/29021880/use-of-titanium-elastic-nails-in-the-adult-diaphyseal-humerus-fractures
#20
A S Upadhyay, N A Lil
Introduction: Humerus shaft fractures in adults can be managed conservatively with functional braces or operatively with plate osteosynthesis or with intramedullary nailing. Conventionally humerus intramedullary nailing is done either using humerus interlocking nails or Enders nails. In this study we analyse the outcome of humerus shaft fractures (upper and middle third) managed with closed ante-grade intramedullary titanium elastic nailing in terms of union rates, union time, functional results and complications...
July 2017: Malaysian Orthopaedic Journal
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