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https://www.readbyqxmd.com/read/29143145/duration-of-viral-shedding-and-factors-associated-with-prolonged-shedding-among-inpatients-with-influenza-treated-with-oseltamivir-a-prospective-cohort-study
#1
J Khoury, M Szwarcwort, Z Kra-Oz, M Saffuri, K Seh, T Yahalomi, E Braun, Z S Azzam, M Paul, A Neuberger
The purpose of this study was to determine the rate of decline in the diagnostic yield of influenza PCR assay after oseltamivir administration, and to identify risk factors for prolonged shedding. This was a prospective observational study. We included adult inpatients with clinical signs of influenza during the influenza seasons 2015 and 2016, who had positive influenza PCR tests and who were treated with oseltamivir. Clinical follow-up and repeat PCR testing were performed on days 2, 4 and 6 after the first positive test...
November 15, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29136256/incidence-of-and-risk-factors-for-inpatient-stroke-after-hip-fractures-in-the-elderly
#2
Andre M Samuel, Pablo J Diaz-Collado, Lauren K Szolomayer, Stephen J Nelson, Matthew L Webb, Adam M Lukasiewicz, Jonathan N Grauer
Although uncommon, stroke can be a catastrophic inpatient complication for patients with hip fractures. The current study determines the incidence of inpatient stroke after hip fractures in elderly patients, identifies risk factors associated with such strokes, and determines the association of stroke with short-term inpatient outcomes. A retrospective review of all patients aged 65 years or older with isolated hip fractures in the 2011 and 2012 National Trauma Data Bank was conducted. A total of 37,584 patients met inclusion criteria...
November 11, 2017: Orthopedics
https://www.readbyqxmd.com/read/29124913/measurement-of-lying-and-standing-blood-pressure-in-hospital
#3
Shelagh O'Riordan, Naomi Vasilakis, Labib Hussain, Rowena Schoo, Julie Whitney, Julie Windsor, Khim Horton, Finbarr Martin
Measuring lying and standing blood pressure (BP) is an important clinical observation in older hospital inpatients. This is because a drop in BP on standing, known as orthostatic hypotension (OH) is common in older people and in acute illness and, therefore, in hospital patients. OH increases the risk of a fall in hospital. Simple measures such as changes in medication or rehydration can reduce this drop in BP and reduce the risk of falls. In a recent snapshot audit in England and Wales of 179 acute hospitals and 4,846 patients aged 65 years and over admitted with an acute illness, only 16% had a lying and standing BP recorded within 48 hours...
September 29, 2017: Nursing Older People
https://www.readbyqxmd.com/read/29110667/a-complex-intervention-to-improve-implementation-of-world-health-organization-guidelines-for-diagnosis-of-severe-illness-in-low-income-settings-a-quasi-experimental-study-from-uganda
#4
Matthew J Cummings, Elijah Goldberg, Savio Mwaka, Olive Kabajaasi, Eric Vittinghoff, Adithya Cattamanchi, Achilles Katamba, Nathan Kenya-Mugisha, Shevin T Jacob, J Lucian Davis
BACKGROUND: To improve management of severely ill hospitalized patients in low-income settings, the World Health Organization (WHO) established a triage tool called "Quick Check" to provide clinicians with a rapid, standardized approach to identify patients with severe illness based on recognition of abnormal vital signs. Despite the availability of these guidelines, recognition of severe illness remains challenged in low-income settings, largely as a result of infrequent vital sign monitoring...
November 6, 2017: Implementation Science: IS
https://www.readbyqxmd.com/read/29036406/effects-of-computerized-decision-support-system-implementations-on-patient-outcomes-in-inpatient-care-a-systematic-review
#5
Julian Varghese, Maren Kleine, Sophia Isabella Gessner, Sarah Sandmann, Martin Dugas
Objectives: To systematically classify the clinical impact of computerized clinical decision support systems (CDSSs) in inpatient care. Materials and Methods: Medline, Cochrane Trials, and Cochrane Reviews were searched for CDSS studies that assessed patient outcomes in inpatient settings. For each study, 2 physicians independently mapped patient outcome effects to a predefined medical effect score to assess the clinical impact of reported outcome effects. Disagreements were measured by using weighted kappa and solved by consensus...
September 23, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28986003/postural-tachycardia-in-hypermobile-ehlers-danlos-syndrome-a-distinct-subtype
#6
Mitchell G Miglis, Brittany Schultz, Srikanth Muppidi
INTRODUCTION: It is not clear if patients with postural tachycardia syndrome (POTS) and Ehlers-Danlos syndrome (hEDS) differ from patients with POTS due to other etiologies. We compared the results of autonomic testing and healthcare utilization in POTS patients with and without hEDS. METHODS: Patients with POTS+hEDS (n=20) and POTS controls without hypermobility (n=20) were included in the study. All patients underwent autonomic testing, and the electronic medical records were reviewed to determine the number and types of medications patients were taking, as well as the number of outpatient, emergency department, and inpatient visits over the prior year...
October 2, 2017: Autonomic Neuroscience: Basic & Clinical
https://www.readbyqxmd.com/read/28984090/bispectral-index-monitored-sevoflurane-requirement-might-be-decreased-in-individuals-with-major-depressive-disorder
#7
Veysel Erden, Cihan Güler, Seda Seven, Sevda Bağ, Ali G Kara, Şenay Kirgezen
BACKGROUND: GABA (γ-aminobutyric acid) is the primary inhibitory neurotransmitter in the CNS and well-known target for general anesthetics. In addition, the dysregulation of GABA could be involved in the etiology of MDD. In this study, we aimed to determine whether MDD has any effect on anesthetic requirement measured by bispectral index (BIS). METHODS: This study was designed as a prospective, observational study, registered ANZCTR (ACTRN12616001295437), with institutional review board approval and written informed consent...
October 4, 2017: Minerva Anestesiologica
https://www.readbyqxmd.com/read/28959484/determinants-of-the-impact-of-blood-pressure-variability-on-neurological-outcome-after-acute-ischaemic-stroke
#8
Adam de Havenon, Alicia Bennett, Gregory J Stoddard, Gordon Smith, Lee Chung, Steve O'Donnell, J Scott McNally, David Tirschwell, Jennifer J Majersik
INTRODUCTION: Increased blood pressure variability (BPV) is detrimental after acute ischaemic stroke, but the interaction between BPV and neuroimaging factors that directly influence stroke outcome has not been explored. METHODS: We retrospectively reviewed inpatients from 2007 to 2014 with acute anterior circulation ischaemic stroke, CT perfusion and angiography at hospital admission, and a modified Rankin Scale (mRS) 30-365 days after stroke onset. BPV indices included SD, coefficient of variation and successive variation of the systolic blood pressure between 0 and 120 hours after admission...
March 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28927644/acute-kidney-injury-is-a-risk-factor-for-subsequent-proteinuria
#9
Sharidan K Parr, Michael E Matheny, Khaled Abdel-Kader, Robert A Greevy, Aihua Bian, James Fly, Guanhua Chen, Theodore Speroff, Adriana M Hung, T Alp Ikizler, Edward D Siew
Acute kidney injury (AKI) is associated with subsequent chronic kidney disease (CKD), but the mechanism is unclear. To clarify this, we examined the association of AKI and new-onset or worsening proteinuria during the 12 months following hospitalization in a national retrospective cohort of United States Veterans hospitalized between 2004-2012. Patients with and without AKI were matched using baseline demographics, comorbidities, proteinuria, estimated glomerular filtration rate, blood pressure, angiotensin-converting enzyme inhibitor or angiotensin II receptor blocker (ACEI/ARB) use, and inpatient exposures linked to AKI...
September 16, 2017: Kidney International
https://www.readbyqxmd.com/read/28926361/association-between-day-by-day-and-ambulatory-blood-pressure-variability-in-type-2-diabetes-patients
#10
Hiroyuki Iuchi, Masaya Sakamoto, Daisuke Matsutani, Hirofumi Suzuki, Yosuke Kayama, Norihiko Takeda, Kazunori Utsunomiya
It remains unclear whether ambulatory blood pressure variability (BPV) contributes toward day-by-day BPV, despite the fact that not only day-by-day but also ambulatory BPV is reported to be a risk factor for type 2 diabetes patients. This study aimed to determine the association between day-by-day BPV and ambulatory BPV, which is especially distinguished between diurnal and nocturnal BPV, in type 2 diabetes patients. Day-by-day and ambulatory BPV were assessed in 30 type 2 diabetes patients (aged 54±15 years; 87% men; glycated hemoglobin: 9...
September 18, 2017: Blood Pressure Monitoring
https://www.readbyqxmd.com/read/28916603/phase-2a-clinical-trial-of-mitochondrial-protection-elamipretide-during-stent-revascularization-in-patients-with-atherosclerotic-renal-artery-stenosis
#11
Ahmed Saad, Sandra M S Herrmann, Alfonso Eirin, Christopher M Ferguson, James F Glockner, Haraldur Bjarnason, Michael A McKusick, Sanjay Misra, Lilach O Lerman, Stephen C Textor
BACKGROUND: Atherosclerotic renal artery stenosis reduces renal blood flow (RBF) and amplifies stenotic kidney hypoxia. Revascularization with percutaneous transluminal renal angioplasty (PTRA) and stenting often fails to recover renal function, possibly because of ischemia/reperfusion injury developing after PTRA. Elamipretide is a mitochondrial-targeted peptide that binds to cardiolipin and stabilizes mitochondrial function. We tested the hypothesis that elamipretide plus PTRA would improve renal function, oxygenation, and RBF in patients with atherosclerotic renal artery stenosis undergoing PTRA...
September 2017: Circulation. Cardiovascular Interventions
https://www.readbyqxmd.com/read/28880609/improved-metabolic-and-psychiatric-outcomes-with-discontinuation-of-atypical-antipsychotics-in-youth-hospitalized-in-a-state-psychiatric-facility
#12
Leslie Hulvershorn, Samantha Parkhurst, Shannon Jones, Kristin Dauss, Caitlin Adams
OBJECTIVES: To assess the impact of antipsychotic tapering and discontinuation on measures of metabolic functioning and psychiatric symptom severity in severely impaired youth hospitalized in a psychiatric state hospital. METHODS: The study examined psychiatric and metabolic measures in 67 hospitalized children and adolescents (mean age 11.9; 56 with discontinued use of antipsychotics, 10 with continued use of antipsychotics, and 1 started on an antipsychotic) from admission to discharge...
September 7, 2017: Journal of Child and Adolescent Psychopharmacology
https://www.readbyqxmd.com/read/28872927/an-investigation-of-cardiovascular-risks-in-a-group-of-children-and-adolescents-who-use-atypical-antipsychotics
#13
Gül Dikeç, Leyla Baysan Arabaci, Gülçin Bölük Uzunoglu, Selin Demet Mizrak
This study was conducted to identify the metabolic parameters and body measurements associated with cardiovascular risks in a group of children and adolescents who as part of inpatient treatment received atypical antipsychotics at a psychiatric hospital in Turkey. Body mass indexes (BMIs), waist circumferences (WCs), diastolic blood pressures (DBPs), systolic blood pressures (SBPs) and heart rates (HRs) of the patients were evaluated during hospitalization and at discharge. A statistically significant difference was found among the mean BMIs, WCs, DBPs and HRs of the patients at the stages of their hospitalization and discharge (p < 0...
October 2017: Issues in Mental Health Nursing
https://www.readbyqxmd.com/read/28813495/establishing-failure-predictors-for-the-planned-extubation-of-overweight-and-obese-patients
#14
Chien-Ming Chao, Chih-Cheng Lai, Ai-Chin Cheng, Shyh-Ren Chiang, Wei-Lun Liu, Chung-Han Ho, Shu-Chen Hsing, Chin-Ming Chen, Kuo-Chen Cheng
We investigated failure predictors for the planned extubation of overweight (body mass index [BMI] = 25.0-29.9) and obese (BMI ≥ 30) patients. All patients admitted to the adult intensive care unit (ICU) of a tertiary hospital in Taiwan were identified. They had all undergone endotracheal intubation for > 48 h and were candidates for extubation. During the study, 595 patients (overweight = 458 [77%]); obese = 137 [23%]) with planned extubation after weaning were included in the analysis; extubation failed in 34 patients (5...
2017: PloS One
https://www.readbyqxmd.com/read/28745786/impacts-of-serum-p-selectin-on-blood-pressure-control-after-pci-in-patients-with-coronary-heart-disease-complicated-with-hypertension
#15
F-F Yang, F Peng, Y-B Xing, M Yuan, X-C Ma, G Li, H-Y Guo
OBJECTIVE: We analyzed the impact of potent anti-hypertension or anti-thrombotic therapy after PCI in patients with coronary heart disease complicated with hypertension, whilst to reflect the prognosis by testing P-selectin. PATIENTS AND METHODS: A total of 177 patients with coronary heart disease (CHD) complicated with hypertension was continuously enrolled in this study and randomly divided into traditional anti-hypertension group (group A: 130/80 mm Hg ≤ BP ≤ 140/90 mm Hg; anti-hypertensive drugs: β blockers and angiotensin converting enzyme inhibitor, n=84) and potent anti-hypertension group (group B: BP <130/80 mm Hg; dosage and frequency in group B > group A, n=93)...
July 2017: European Review for Medical and Pharmacological Sciences
https://www.readbyqxmd.com/read/28693601/effects-of-the-plate-model-as-part-of-dietary-intervention-on-modification-of-selected-cardiometabolic-risk-factors-in-post-myocardial-infarction-patients-study-protocol-for-a-randomized-controlled-trial
#16
Ranil Jayawardena, Pasindu Fernando, Niroshan Lokunarangoda, Anidu Keerthi Pathirana
BACKGROUND: Cardiovascular disease remains the leading cause of morbidity and mortality worldwide, and there is a rising global burden. The effects of diet on cardiometabolic risk factors have been studied extensively. Healthy eating as a cost-effective approach to risk reduction in post-myocardial infarction patients is proven to be beneficial, and the "plate model" is one of the practical methods to achieve this objective. METHODS/DESIGN: The study will be conducted as a randomized, single-blind, controlled clinical trial for a period of 3 months...
July 10, 2017: Trials
https://www.readbyqxmd.com/read/28682951/preoperatively-screened-obstructive-sleep-apnea-is-associated-with-worse-postoperative-outcomes-than-previously-diagnosed-obstructive-sleep-apnea
#17
Ana Fernandez-Bustamante, Karsten Bartels, Claudia Clavijo, Benjamin K Scott, Rachel Kacmar, Kenneth Bullard, Angela F D Moss, William Henderson, Elizabeth Juarez-Colunga, Leslie Jameson
BACKGROUND: Obstructive sleep apnea (OSA) affects up to 26% of US adults, is often undiagnosed, and increases perioperative morbidity. We hypothesized that patients screened on the day of surgery as moderate/high risk for OSA (S-OSA) present similar perioperative respiratory complications, hospital use, and mortality than patients with previously diagnosed OSA (D-OSA). Second, we hypothesized that both OSA groups have more respiratory complications than No-OSA patients. METHODS: The electronic medical database from 1 academic and 2 community hospitals was retrospectively queried to identify adults undergoing nonemergent inpatient surgery (January 1, 2012, to December 31, 2014)...
August 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28639305/standard-laboratory-tests-are-recommended-as-supplements-to-the-braden-scale-for-pressure-ulcer-risk
#18
Man-Li Zha, Hong-Lin Chen
We read the article with the great interest written by Skogestad IJ et al. on the supplements to the Braden scale for pressure ulcer risk among medical inpatients(Skogestad et al. 2017). In this prospective, cross-sectional survey, which involved 328 medical inpatients and aimed to describe the prevalence of pressure ulcers and pressure ulcer risk in medical patients and to detect possible risk factors, including sociodemographic factors, comorbidities, symptom experience and laboratory blood values, the authors found that patient-reported symptoms and standard laboratory results served as supplemental indicators of pressure ulcer risk may improve identification of patients at risk of pressure ulcer...
June 21, 2017: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/28612712/subcutaneous-injection-induced-cellulites
#19
Kao-Chi Cheng, Po-Tsung Huang, Chiu-Shong Liu, Wen-Yuan Lin
In the hospice ward where patients are in the terminal stages of cancer, it is common practice to give them a subcutaneous injection of pain relievers to reduce their pain and make them more comfortable. Most of these patients are elderly and have low blood pressure or poor veins, which often makes it difficult to inject them because of the calcification at previous injection sites. Thus, subcutaneous injections are a convenient way to maintain analgesia and patient comfort. Our patient, a 73-year-old aboriginal woman, was diagnosed with gastric adenocarcinoma and peritoneal carcinomatosis in March, 2004...
June 2017: BioMedicine
https://www.readbyqxmd.com/read/28598799/clinical-outcomes-of-an-inpatient-pediatric-obesity-treatment-program-in-the-usa
#20
Sharonda J Alston Taylor, Kimberly Rennie, Cindy Jon
Background When treating recalcitrant and severe childhood obesity, pharmaceutical options are limited and few patients qualify for bariatric surgery. A prolonged inpatient program serves as an alternative treatment. The purpose of this project was to describe the development of a medically supervised inpatient weight management program and evaluate its effectiveness. Methods This is a retrospective chart review of 18 patients [4-18 years, mean body mass index (BMI) 50.2 kg/m2] admitted to an inpatient pediatric weight management program from October 2011 through December 31, 2012 to evaluate the biometric, laboratory, sleep and behavioral changes that occurred from admission to discharge from the program...
June 9, 2017: International Journal of Adolescent Medicine and Health
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