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https://www.readbyqxmd.com/read/29655388/the-prevalence-of-healthcare-associated-infections-in-mainland-china-a-systematic-review-and-meta-analysis
#1
Jiancong Wang, Fangfei Liu, Ermira Tartari, Jianan Huang, Stephan Harbarth, Didier Pittet, Walter Zingg
OBJECTIVETo assess the prevalence of healthcare-associated infections (HAIs) in mainland China.DESIGNSystematic review and meta-analysis.SETTINGAdults and children from secondary and tertiary acute-care hospitals in mainland China.METHODSWe searched PubMed, the China National Knowledge Infrastructure, and Wan Fang for multicenter point-prevalence surveys of acute-care hospitals in mainland China from January 2006 to August 2016. All reports related to HAI, using a point-prevalence methodology and published either in English or Chinese were eligible...
April 15, 2018: Infection Control and Hospital Epidemiology
https://www.readbyqxmd.com/read/29649611/predictors-of-adverse-discharge-disposition-in-adult-spinal-deformity-and-associated-costs
#2
Peter G Passias, Gregory W Poorman, Cole A Bortz, Rabia Qureshi, Bassel G Diebo, Justin C Paul, Samantha R Horn, Frank A Segreto, Alexandra Pyne, Cyrus M Jalai, Virginie Lafage, Shay Bess, Frank J Schwab, Hamid Hassanzadeh
BACKGROUND CONTEXT: With advances in the understanding of adult spinal deformity (ASD), more complex osteotomy and fusion techniques are being implemented with increasing frequency. Patients undergoing ASD corrections infrequently require extended acute care, longer inpatient stays, and are discharged to supervised care. Given the necessity of value-based health care, identification of clinical indicators for adverse discharge disposition in ASD surgeries is paramount. PURPOSE: On nationwide and surgeon-created databases, identify predictors of adverse discharge disposition after ASD surgeries and view corresponding differences in charges...
April 9, 2018: Spine Journal: Official Journal of the North American Spine Society
https://www.readbyqxmd.com/read/29649400/impact-of-inpatient-palliative-care-on-quality-of-end-of-life-care-and-downstream-acute-and-postacute-care-utilization
#3
Peter S Khang, Susan E Wang, In-Lu Amy Liu, Heather L Watson, Sandra Y Koyama, Dan N Huynh, Janet S Lee, Huong Q Nguyen
BACKGROUND: Additional evidence is needed regarding the impact of inpatient palliative care (IPC) on the quality of end-of-life care and downstream utilization. AIM: Examine the effects of IPC on quality of end-of-life care and acute and postacute care use in a large integrated system. DESIGN: Retrospective cohort design. SETTING/PARTICIPANTS: Adult decedents from January 1, 2012, to December 31, 2014, who had at least one hospitalization at 11 Kaiser Permanente Southern California medical centers in the 12 months before death and not hospitalized for a trauma-related condition or receiving home-based PC or hospice were included in the cohort...
March 13, 2018: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/29649285/cost-of-gastroenteritis-in-australia-a-healthcare-perspective
#4
S Fiona Barker, Ella Zomer, Joanne O'Toole, Martha Sinclair, Katherine Gibney, Danny Liew, Karin Leder
BACKGROUND: Acute gastroenteritis illness is a common illness that causes considerable morbidity, but current estimates of the cost to the Australian healthcare system are unknown. OBJECTIVE: To estimate the current healthcare utilisation and direct public healthcare system costs attributable to acute gastroenteritis illness in Australia. METHODS: This is an incidence-based cost-of-illness study focused on quantifying direct health care costs using a bottom-up approach...
2018: PloS One
https://www.readbyqxmd.com/read/29649032/airway-management-practice-in-adults-with-an-unstable-cervical-spine-the-harborview-medical-center-experience
#5
Michael G Holmes, Armagan Dagal, Bryan A Feinstein, Aaron M Joffe
BACKGROUND: Airway management in the presence of acute cervical spine injury (CSI) is challenging. Because it limits cervical spine motion during tracheal intubation and allows for neurological examination after the procedure, awake fiberoptic bronchoscopy (FOB) has traditionally been recommended. However, with the widespread availability of video laryngoscopy (VL), its use has declined dramatically. Our aim was to describe the frequency of airway management techniques used in patients with CSI at our level I trauma center and report the incidence of neurological injury attributable to airway management...
April 11, 2018: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29644701/usefulness-of-national-respiratory-virus-surveillance-data-for-clinicians-who-manage-adult-patients
#6
Eun Been Cho, Seong-Ho Choi, Jin-Won Chung, Mi-Kyung Lee
The Korean Centers for Disease Control and Prevention (KCDC) provides weekly respiratory virus (RV) surveillance reports on its website (the KCDC data). Clinicians in clinical settings wherein the use of PCR for RVs is not a routine laboratory test for adult patients with acute respiratory illness (ARI) may question the clinical utility of such a national RV surveillance dataset in predicting RV outbreaks among their adult patients. We compared the KCDC data to the RV PCR data of adult patients who visited a tertiary care center...
April 12, 2018: Journal of Medical Virology
https://www.readbyqxmd.com/read/29644618/adherence-to-basal-insulin-therapy-among-people-with-type-2-diabetes-a-retrospective-cohort-study-of-costs-and-patient-outcomes
#7
Magaly Perez-Nieves, Kristina S Boye, Jacek Kiljanski, Dachung Cao, Maureen J Lage
INTRODUCTION: This research compares costs, resource utilization, and complications between adherent and nonadherent patients over the 3-year period post initiation on basal insulin therapy. METHODS: The study utilized the US-based Truven Health MarketScan® Research Databases from 2011 through 2015. Adults aged 18 years or older and identified with type 2 diabetes (T2D) who initiated therapy on basal insulin in 2012 were included. Patients were excluded if they were pregnant, filled their index basal insulin prescription via mail order, or were not continuously insured from 1 year before through 3 years following initiation of treatment with basal insulin...
April 11, 2018: Diabetes Therapy: Research, Treatment and Education of Diabetes and related Disorders
https://www.readbyqxmd.com/read/29643160/using-machine-learning-techniques-to-develop-forecasting-algorithms-for-postoperative-complications-protocol-for-a-retrospective-study
#8
Bradley A Fritz, Yixin Chen, Teresa M Murray-Torres, Stephen Gregory, Arbi Ben Abdallah, Alex Kronzer, Sherry Lynn McKinnon, Thaddeus Budelier, Daniel L Helsten, Troy S Wildes, Anshuman Sharma, Michael Simon Avidan
INTRODUCTION: Mortality and morbidity following surgery are pressing public health concerns in the USA. Traditional prediction models for postoperative adverse outcomes demonstrate good discrimination at the population level, but the ability to forecast an individual patient's trajectory in real time remains poor. We propose to apply machine learning techniques to perioperative time-series data to develop algorithms for predicting adverse perioperative outcomes. METHODS AND ANALYSIS: This study will include all adult patients who had surgery at our tertiary care hospital over a 4-year period...
April 10, 2018: BMJ Open
https://www.readbyqxmd.com/read/29642928/diagnostic-and-management-of-life-threatening-adult-onset-still-disease-a-french-nationwide-multicenter-study-and-systematic-literature-review
#9
Antoine Néel, Anaïs Wahbi, Benoit Tessoulin, Julien Boileau, Dorothée Carpentier, Olivier Decaux, Laurence Fardet, Guillaume Geri, Pascal Godmer, Cécile Goujard, Hervé Maisonneuve, Arnaud Mari, Jacques Pouchot, Jean-Marc Ziza, Cédric Bretonnière, Mohamed Hamidou
BACKGROUND: Adult-onset Still disease (AOSD) is a rare systemic inflammatory disorder. A few patients develop organ complications that can be life-threatening. Our objectives were to describe the disease course and phenotype of life-threatening AOSD, including response to therapy and long-term outcome. METHODS: A multicenter case series of intensive care medicine (ICU) patients with life-threatening AOSD and a systematic literature review. RESULTS: Twenty patients were included...
April 11, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29628828/pain-assessment-in-the-critically-ill-mechanically-ventilated-adult-patients-comparison-between-skin-conductance-algesimeter-index-and-physiologic-indicators
#10
Puneet Khanna, Chandralekha Chandralekha, Ravinder Kumar Pandey, Ankur Sharma
Background and Objectives: Critically ill patients are unable to communicate effectively, so it is difficult to assess their pain and analgesic requirement. Skin conductance algesimeter (SCA) index is a device that primarily measures changes in skin conductance real time to assess pain. Methods: We planned this quantitative prospective observational study to assess pain in the critically ill mechanically ventilated patients in comparison to physiologic indicators such as blood pressure and heart rate...
April 2018: Saudi Journal of Anaesthesia
https://www.readbyqxmd.com/read/29628416/can-we-incorporate-geriatric-assessment-in-the-management-of-acute-lymphoblastic-leukemia-in-older-adults
#11
Kah Poh Loh, Jane L Liesveld, Kristen M O'Dwyer
Acute lymphoblastic leukemia (ALL) is an uncommon disease. Approximately 14% of new ALL cases occur in adults aged 60 and over, and the three-year overall survival in this population is poor at 12.8%. Older adults with ALL are heterogeneous in terms of their underlying health status, which can make treatment selection challenging given the disease rarity and limited inclusion of older patients in clinical trials. A comprehensive geriatric assessment (CGA) is a compilation of tools to assess multiple domains such as physical function and cognition, and may assist in guiding treatment selection and supportive care interventions...
April 5, 2018: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/29628190/prognostic-utility-of-initial-lactate-in-patients-with-acute-drug-overdose-a-validation-cohort
#12
Randy Cheung, Robert S Hoffman, David Vlahov, Alex F Manini
STUDY OBJECTIVE: Previous studies have suggested that the initial emergency department (ED) lactate concentration may be an important prognostic indicator for inhospital mortality from acute drug poisoning. We conduct this cohort study to formally validate the prognostic utility of the initial lactate concentration in a larger, distinct patient population with acute drug overdose. METHODS: This observational, prospective, cohort study was conducted during 5 years at 2 urban teaching hospitals...
April 6, 2018: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/29628154/-severity-of-disease-scoring-systems-and-mortality-after-non-cardiac-surgery
#13
Pedro Videira Reis, Gabriela Sousa, Ana Martins Lopes, Ana Vera Costa, Alice Santos, Fernando José Abelha
BACKGROUND: Mortality after surgery is frequent and severity of disease scoring systems are used for prediction. Our aim was to evaluate predictors for mortality after non-cardiac surgery. METHODS: Adult patients admitted at our surgical intensive care unit between January 2006 and July 2013 was included. Univariate analysis was carried using Mann-Whitney, Chi-square or Fisher's exact test. Logistic regression was performed to assess independent factors with calculation of odds ratio and 95% confidence interval (95% CI)...
April 5, 2018: Revista Brasileira de Anestesiologia
https://www.readbyqxmd.com/read/29628015/clinical-outcomes-of-weight-based-norepinephrine-dosing-in-underweight-and-morbidly-obese-patients-a-propensity-matched-analysis
#14
Aditya A Kotecha, Saraschandra Vallabhajosyula, Dinesh R Apala, Erin Frazee, Vivek N Iyer
BACKGROUND: Weight-based dosing strategy for norepinephrine in septic shock patients with extremes of body mass index has been lesser studied. METHODS: This historical study of adult septic shock patients was conducted from January 1, 2010, to December 31, 2015, at all intensive care units (ICUs) in Mayo Clinic, Rochester. Patients with documented body mass index were classified into underweight (body mass index <18.5 kg/m2 ), normal weight (18.5-24.9 kg/m2 ), and morbidly obese (≥40 kg/m2 ) patients...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29628014/invasive-candidiasis-in-critically-ill-patients-a-prospective-cohort-study-in-2-tertiary-care-centers
#15
Hasan M Al-Dorzi, Hussam Sakkijha, Raymond Khan, Tarek Aldabbagh, Aron Toledo, Pendo Ntinika, Sameera M Al Johani, Yaseen M Arabi
BACKGROUND: Invasive candidiasis is not uncommon in critically ill patients but has variable epidemiology and outcomes between intensive care units (ICUs). This study evaluated the epidemiology, characteristics, management, and outcomes of patients with invasive candidiasis at 6 ICUs of 2 tertiary care centers. METHODS: This was a prospective observational study of all adults admitted to 6 ICUs in 2 different hospitals between August 2012 and May 2016 and diagnosed to have invasive candidiasis by 2 intensivists according to predefined criteria...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29624189/improving-the-safety-of-opioid-use-for-acute-noncancer-pain-in-hospitalized-adults-a-consensus-statement-from-the-society-of-hospital-medicine
#16
Shoshana J Herzig, Hilary J Mosher, Susan L Calcaterra, Anupam B Jena, Teryl K Nuckols
Hospital-based clinicians frequently treat acute, noncancer pain. Although opioids may be beneficial in this setting, the benefits must be balanced with the risks of adverse events, including inadvertent overdose and prolonged opioid use, physical dependence, or development of opioid use disorder. In an era of epidemic opioid use and related harms, the Society of Hospital Medicine (SHM) convened a working group to develop a consensus statement on opioid use for adults hospitalized with acute, noncancer pain, outside of the palliative, end-of-life, and intensive care settings...
April 2018: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29624086/does-acute-myocardial-infarction-kill-more-people-on-weekends-analysis-of-in-hospital-mortality-rates-for-weekend-admissions-in-portugal
#17
Francesca Fiorentino, Raquel Ascenção, Nicoletta Rosati
Objectives To investigate a possible weekend effect in the in-hospital mortality rate for acute myocardial infarction in Portugal, and whether the delay in invasive intervention contributes to this effect. Methods Data from the National 2011-2015 Diagnostic-Related-Group databases were analysed. The focus was on adult patients admitted via the emergency department and with the primary diagnosis of acute myocardial infarction. Patients were grouped according to ST-elevation myocardial infarction and non-ST-elevation myocardial infarction episodes...
January 1, 2018: Journal of Health Services Research & Policy
https://www.readbyqxmd.com/read/29622165/respiratory-syncytial-virus-and-associations-with-cardiovascular-disease-in-adults
#18
REVIEW
Kelsey S Ivey, Kathryn M Edwards, H Keipp Talbot
Respiratory syncytial virus (RSV) is historically known for causing respiratory illness in young children, but the appreciation of its impact on older adults is growing. Studies have shown that hospitalization for respiratory illness due to RSV is complicated by cardiovascular events in 14% to 22% of adult patients, including worsening congestive heart failure, acute coronary syndrome, and arrhythmias. Additionally, underlying cardiovascular disease is associated with hospitalization in 45% to 63% of adults with confirmed RSV...
April 10, 2018: Journal of the American College of Cardiology
https://www.readbyqxmd.com/read/29621834/application-of-accelerated-time-models-to-compare-performance-of-two-comorbidity-adjusting-methods-with-apache-ii-in-predicting-short-term-mortality-among-the-critically-ill
#19
George Mnatzaganian, Melanie Bish, Jason Fletcher, Cameron Knott, John Stephenson
OBJECTIVE: This study aimed to determine how the abilities of the Charlson Index and Elixhauser comorbidities compared with the chronic health components of the Acute Physiology and Chronic Health Evaluation (APACHE II) to predict in-hospital 30 day mortality among adult critically ill patients treated inside and outside of Intensive Care Unit (ICU). METHODS: A total of 701 critically ill patients, identified in a prevalence study design on four randomly selected days in five acute care hospitals, were followed up from the date of becoming critically ill for 30 days or until death, whichever occurred first...
February 2018: Methods of Information in Medicine
https://www.readbyqxmd.com/read/29619212/validity-of-maternal-report-of-care-seeking-for-childhood-illness
#20
Emily D Carter, Micky Ndhlovu, Melinda Munos, Emmy Nkhama, Joanne Katz, Thomas P Eisele
Background: Accurate data on care-seeking for child illness are needed to improve public health programs and reduce child mortality. The accuracy of maternal report of care-seeking for child illness as collected through household surveys has not been validated. Methods: A 2016 survey compared reported care-seeking against a gold-standard of health care provider documented care-seeking events among a random sample of mothers of children <5 years in Southern Province, Zambia...
June 2018: Journal of Global Health
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