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https://www.readbyqxmd.com/read/29227977/red-blood-cell-distribution-width-is-an-independent-predictor-of-aki-and-mortality-in-patients-in-the-coronary-care-unit
#1
Yugang Hu, Huilan Liu, Shuai Fu, Jing Wan, Xiaoning Li
BACKGROUND/AIMS: We investigated the hypothesis that RDW is an independent predictor of acute kidney injury (AKI) and mortality in patients in the coronary care unit (CCU). METHODS: In this prospective, observational study, we screened 412 adults admitted to the CCU at Zhongnan Hospital of Wuhan University from January 1, 2014 to June 1, 2015. AKI was defined based on the KDIGO-AKI criteria. The survivors were followed up for up to 2 years after hospital discharge...
December 8, 2017: Kidney & Blood Pressure Research
https://www.readbyqxmd.com/read/29227336/family-caregivers-experiences-of-within-hospital-handoffs-for-older-adults-in-acute-care
#2
Alycia A Bristol, Janice D Crist, Linda R Phillips, Kimberly D Shea, Cheryl Lacasse
Family caregivers' experiences during within-hospital handoffs between acute care units are not well understood. Qualitative description methodology was employed to describe family caregivers' experiences during their loved ones' handoffs. Semistructured interviews were conducted with 10 caregivers of hospitalized older adults. Three themes emerged: Lack of care coordination, Muddling through handoffs alone, and Wariness toward the care delivery system. Findings can help clinicians shape their interactions with caregivers to maximize their involvement in post-hospital care...
December 8, 2017: Journal of Nursing Care Quality
https://www.readbyqxmd.com/read/29224940/results-of-nonoperative-management-of-acute-limb-ischemia-in-infants
#3
S Keisin Wang, Gary W Lemmon, Natalie A Drucker, Raghu L Motaganahalli, Michael C Dalsing, Ashley R Gutwein, Brian W Gray, Michael P Murphy
OBJECTIVE: Acute limb ischemia (ALI) in infants poses a challenge to the clinician secondary to poor operative outcomes, limb loss risk, and lifelong morbidity. This retrospective study reviewed a 10-year institutional experience with the nonoperative management of ALI in infants. METHODS: Infants (aged ≤12 months) diagnosed with ALI by duplex ultrasound and treated with initial nonoperative management at a tertiary care children's hospital were identified through vascular laboratory arterial duplex ultrasound records and International Classification of Diseases and Current Procedural Terminology codes associated with ALI...
December 7, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29222706/acute-toxicity-of-fresh-and-aged-residues-of-pesticides-to-the-parasitoid-tamarixia-radiata-and-to-the-hlb-bacteria-vector-diaphorina-citri
#4
V H Beloti, G R Alves, R A Moral, C G B Demétrio, P T Yamamoto
One method for controlling the Asian citrus psyllid (ACP) Diaphorina citri Kuwayama, the vector of the putative causal agent of Huanglongbing, uses the parasitoid Tamarixia radiata (Waterston). However, the general intensive use of insecticides has reduced the numbers of this parasitoid. This study evaluated the effect of the residual action of 24 insecticides on T. radiata and also determined the differential toxicity of insecticides to D. citri and T. radiata, using three bioassays. In the first, when adults of the parasitoid were exposed to residues of the 24 insecticides, ten were considered short-life (class 1), six slightly persistent (class 2), five moderately persistent (class 3), and three insecticides were considered persistent (class 4), under the IOBC/WPRS classification system...
December 8, 2017: Neotropical Entomology
https://www.readbyqxmd.com/read/29222301/optimizing-the-care-model-for-an-uncomplicated-acute-pain-episode-in-sickle-cell-disease
#5
REVIEW
Paul Telfer, Banu Kaya
The pathophysiology, clinical presentation, and natural history of acute pain in sickle cell disease are unique and require a disease-centered approach that also applies general principles of acute and chronic pain management. The majority of acute pain episodes are managed at home without the need to access health care. The long-term consequences of poorly treated acute pain include chronic pain, adverse effects of chronic opioid usage, psychological maladjustment, poor quality of life, and excessive health care utilization...
December 8, 2017: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/29221484/the-impacts-of-baseline-ventilator-parameters-on-hospital-mortality-in-acute-respiratory-distress-syndrome-treated-with-venovenous-extracorporeal-membrane-oxygenation-a-retrospective-cohort-study
#6
Meng-Yu Wu, Yu-Sheng Chang, Chung-Chi Huang, Tzu-I Wu, Pyng-Jing Lin
BACKGROUND: Venovenous extracorporeal membrane oxygenation (VV-ECMO) is a valuable life support in acute respiratory distress syndrome (ARDS) in adult patients. However, the success of VV-ECMO is known to be influenced by the baseline settings of mechanical ventilation (MV) before its institution. This study was aimed at identifying the baseline ventilator parameters which were independently associated with hospital mortality in non-trauma patients receiving VV-ECMO for severe ARDS. METHODS: This retrospective study included 106 non-trauma patients (mean age: 53 years) who received VV-ECMO for ARDS in a single medical center from 2007 to 2016...
December 8, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/29219876/effectiveness-of-patient-centered-interventions-on-falls-in-the-acute-care-setting-compared-to-usual-care-a-systematic-review
#7
Donna Avanecean, Dawn Calliste, Teresita Contreras, Yeogyeong Lim, Aileen Fitzpatrick
BACKGROUND: Unintentional falls during hospitalization remain a concern for healthcare institutions globally despite implementation of various improvement strategies. Although the incidence of falls has been of heightened focus for many years and numerous studies have been done evaluating different approaches for fall prevention, fall rates remain high in acute care settings. Patient fall risk scales tend to address only particular intrinsic and extrinsic factors but do not adequately assess a patient's current fall risk status, subsequently warranting more patient-centered risk assessments and interventions...
December 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/29219828/improving-care-for-older-patients-in-the-acute-setting-a-qualitative-study-with-healthcare-providers
#8
C Brouwers, H Merten, M Willems, D J Habraken, F W Bloemers, T H Biesheuvel, L S van Galen, P W B Nanayakkara, C Wagner
BACKGROUND: The proportion of older people needing acute care is rapidly growing, thereby posing an increased burden on the acute care chain. The aim of this study is to gain more insight into the obstacles and potential improvement opportunities of the acute care process for older patients arriving at the hospital. METHODS: Semi-structured interviews were conducted to determine the experiences of 18 different primary (i.e. general practitioner, community nurse) and secondary healthcare professionals (i...
October 2017: Netherlands Journal of Medicine
https://www.readbyqxmd.com/read/29218817/impact-of-a-shared-decision-making-intervention-on-healthcare-utilization-a-secondary-analysis-of-the-chest-pain-choice-multicenter-randomized-trial
#9
Jason T Schaffer, Erik P Hess, Judd E Hollander, Jeffrey A Kline, Carlos A Torres, Deborah B Diercks, Russell Jones, Kelly P Owen, Zachary F Meisel, Michel Demers, Annie Leblanc, Jonathan Inselman, Jeph Herrin, Victor M Montori, Nilay D Shah
BACKGROUND: Patients at low risk for acute coronary syndrome (ACS) are frequently admitted for observation and cardiac testing, resulting in substantial burden and cost to the patient and the healthcare system. OBJECTIVES: The purpose of this investigation was to measure the effect of the Chest Pain Choice decision aid (CPC) on overall healthcare utilization as well as utilization of specific services both during the index emergency department visit and in the subsequent 45 days...
December 8, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29218798/high-risk-clinical-features-for-acute-aortic-dissection-a-case-control-study
#10
Robert Ohle, Justin Um, Omar Anjum, Helena Bleeker, Lindy Luo, George Wells, Jeffrey J Perry
BACKGROUND: Acute aortic dissection (AAD) is a rare condition with a high mortality that is often missed. The objective of our study was to assess the diagnostic accuracy of clinical and laboratory findings for AAD, in confirmed cases of AAD and a low risk control group. METHODS: Historical matched case-control study: participants were adults >18 years old presenting to two tertiary care emergency departments (ED) or one regional cardiac referral center. CASES: new ED or in-hospital diagnosis of non-traumatic AAD confirmed by computed tomography or echocardiography...
December 8, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/29216937/-significance-of-peripheral-perfusion-index-in-early-diagnosis-and-goal-directed-therapy-of-septic-shock-patients-a-prospective-single-blind-randomized-controlled-trial
#11
Yuanfeng Shi, Ruihong Yin, Yanli Wang, Jiguang Li, Xiaobing Chen, Yongpeng Xie, Caihong Gu, Xiuzhen Zou, Kexi Liu
OBJECTIVE: To investigate the application of peripheral perfusion index (PPI) in early diagnosis and goal-directed therapy of septic shock, and to provide reference for the early clinical diagnosis and treatment of septic shock. METHODS: A prospective single-blind randomized controlled trial (RCT) was conducted. Adult patients with sepsis admitted to emergency medical department and intensive care unit (ICU) of the First People's Hospital of Lianyungang City in Jiangsu Province from January 2013 to December 2016 were enrolled...
December 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29216846/reduced-level-of-arousal-and-increased-mortality-in-adult-acute-medical-admissions-a-systematic-review-and-meta-analysis
#12
Amy Todd, Samantha Blackley, Jennifer K Burton, David J Stott, E Wesley Ely, Zoë Tieges, Alasdair M J MacLullich, Susan D Shenkin
BACKGROUND: Reduced level of arousal is commonly observed in medical admissions and may predict in-hospital mortality. Delirium and reduced level of arousal are closely related. We systematically reviewed and conducted a meta-analysis of studies in adult acute medical patients of the relationship between reduced level of arousal on admission and in-hospital mortality. METHODS: We conducted a systematic review (PROSPERO: CRD42016022048), searching MEDLINE and EMBASE...
December 8, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/29215080/risk-predictors-and-outcomes-of-acute-kidney-injury-in-patients-admitted-to-intensive-care-units-in-egypt
#13
Samar Abd ElHafeez, Giovanni Tripepi, Robert Quinn, Yasmine Naga, Sherif Abdelmonem, Mohamed AbdelHady, Ping Liu, Matthew James, Carmine Zoccali, Pietro Ravani
Epidemiology of acute kidney injury (AKI) in developing countries is under-studied. We evaluated the risk and prognosis of AKI in patients admitted to intensive care units (ICUs) in Egypt. We recruited consecutive adults admitted to ICUs in Alexandria Teaching Hospitals over six months. We used the KDIGO criteria for AKI. We followed participants until the earliest of ICU discharge, death, day 30 from entry or study end. Of the 532 participants (median age 45 (Interquartile range [IQR]: 30-62) years, 41.7% male, 23...
December 7, 2017: Scientific Reports
https://www.readbyqxmd.com/read/29211830/antibiotic-utilization-and-the-role-of-suspected-and-diagnosed-mosquito-borne-illness-among-adults-and-children-with-acute-febrile-illness-in-pune-india
#14
Matthew Robinson, Dileep Kadam, Anju Kagal, Sandhya Khadse, Aarti Kinikar, Chhaya Valvi, Anita Basavaraj, Renu Bharadwaj, Ivan Marbaniang, Savita Kanade, Priyanka Raichur, Jonathan Sachs, Eili Klein, Sara Cosgrove, Amita Gupta, Vidya Mave
Background: Antibiotic resistance mechanisms originating in low- and middle- income countries are among the most common worldwide. Reducing unnecessary antibiotic use in India, the world's largest antibiotic consumer is crucial to control antimicrobial resistance globally. Limited data describing factors influencing Indian clinicians to start or stop antibiotics is available. Methods: Febrile adults and children admitted to a public tertiary care hospital in Pune, India were enrolled...
December 4, 2017: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29211187/the-epimed-monitor-icu-database%C3%A2-a-cloud-based-national-registry-for-adult-intensive-care-unit-patients-in-brazil
#15
Fernando Godinho Zampieri, Márcio Soares, Lunna Perdigão Borges, Jorge Ibrain Figueira Salluh, Otávio Tavares Ranzani
OBJECTIVE: To describe the Epimed Monitor Database®, a Brazilian intensive care unit quality improvement database. METHODS: We described the Epimed Monitor® Database, including its structure and core data. We presented aggregated informative data from intensive care unit admissions from 2010 to 2016 using descriptive statistics. We also described the expansion and growth of the database along with the geographical distribution of participating units in Brazil...
November 30, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/29210750/insights-about-the-economic-impact-of-chronic-obstructive-pulmonary-disease-readmissions-post-implementation-of-the-hospital-readmission-reduction-program
#16
Valerie G Press, R Tamara Konetzka, Steven R White
PURPOSE OF REVIEW: Chronic obstructive pulmonary disease (COPD) affects over 12 million adults in the United States and is the third leading cause of 30-day readmissions. COPD is costly with almost $50 billion in direct costs annually. Total COPD costs can be up to double the identified direct costs because of comorbid disease and numerous indirect costs such as absenteeism. Acute exacerbations of COPD (AECOPD) are responsible for up to 70% of COPD-related healthcare costs; hospital readmissions alone account for over $15 billion annually...
November 27, 2017: Current Opinion in Pulmonary Medicine
https://www.readbyqxmd.com/read/29210058/development-and-internal-validation-of-the-simplified-mortality-score-for-the-intensive-care-unit-sms-icu
#17
A Granholm, A Perner, M Krag, P B Hjortrup, N Haase, L B Holst, S Marker, M O Collet, A K G Jensen, M H Møller
BACKGROUND: Intensive care unit (ICU) mortality prediction scores deteriorate over time, and their complexity decreases clinical applicability and commonly causes problems with missing data. We aimed to develop and internally validate a new and simple score that predicts 90-day mortality in adults upon acute admission to the ICU: the Simplified Mortality Score for the Intensive Care Unit (SMS-ICU). METHODS: We used data from an international cohort of 2139 patients acutely admitted to the ICU and 1947 ICU patients with severe sepsis/septic shock from 2009 to 2016...
December 6, 2017: Acta Anaesthesiologica Scandinavica
https://www.readbyqxmd.com/read/29208883/tumor-lysis-syndrome-and-hyperleukocytosis-in-childhood-acute-lymphoblastic-leukemia-in-a-tertiary-care-hospital
#18
R Tasmeen, A Islam, S T Alam, M Begum
Acute lymphoblastic leukemia is the most common (77%) childhood leukemia and also the most common neoplastic disease in children. Acute lymphoblastic leukemia initially present with hyperleukocytosis (WBC count more than 50,000/mm³) in twenty percent cases. These children are particularly at risk of development of tumor lysis syndrome (TLS). Tumor lysis syndrome is a metabolic disorder consists of hyperuricaemia, hyperkalemia, hyperphosphataemia, hypocalcaemia with or without renal insufficiency. It is the most common disease related emergency encountered by physicians caring for cancer of children and adult...
October 2017: Mymensingh Medical Journal: MMJ
https://www.readbyqxmd.com/read/29207887/burn-care-and-rehabilitation-in-australia-health-professionals-perspectives
#19
Rachel Kornhaber, Greg Rickard, Loyola McLean, Rick Wiechula, Violeta Lopez, Michelle Cleary
OBJECTIVE: To understand health professionals' perspectives of burn care and rehabilitation. DESIGN: Qualitative and semi-structured interviews. SETTING: Australian burn and rehabilitation units. PARTICIPANTS: Twenty-two clinicians working in burns units across disciplines and healthcare settings. RESULTS: The data portrayed the health professionals' perspectives of burn care and rehabilitation in Australia...
December 5, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/29204020/predictors-of-in-hospital-mortality-of-acute-ischemic-stroke-in-adult-population
#20
Bhupendra Shah, Bijay Bartaula, Janak Adhikari, Hari Shankar Neupane, Birendra Prasad Shah, Gunaraj Poudel
Introduction: Stroke is the second most common cause of mortality worldwide. Data regarding the predictors of mortality of acute ischemic stroke are widely discordant. Identifying the predictors and providing the utmost care to a high-risk patient is still an unmet need in middle- to low-income countries. We did this study to identify the predictor of in-hospital mortality of acute ischemic stroke. Materials and Methods: We conducted a retrospective study of patients with acute ischemic stroke presented to the tertiary care center in eastern Nepal from January 2012 to December 2016...
October 2017: Journal of Neurosciences in Rural Practice
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