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https://www.readbyqxmd.com/read/29783937/enterococcus-gallinarum-meningitis-a-case-report-and-literature-review
#1
Bo Zhao, Mao Sheng Ye, Rui Zheng
BACKGROUND: As an opportunistic pathogen, E. gallinarum mainly leads to nosocomial infections, and it's multi-drug resistance has gained more and more attention. Central nervous system infections caused by E. gallinarum are rare, but have been reported more often in recent years. The previous cases were generally secondary to neurosurgery, especially ventriculoperitoneal shunts. In recent years, the cases largely occurred in patients with impaired immune function. The patient in our report may have had dual risk factors (immune impairment and an invasive surgical procedure)...
May 21, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29767825/-palliative-sedation-development-and-consensus-of-a-german-language-documentation-template
#2
C Klein, C Wittmann, K N Wendt, C Ostgathe, S Stiel
BACKGROUND: Palliative sedation (PS) serves as a therapeutic option in cases of otherwise intractable suffering. As the use of sedative and hypnotic medication in many diverse situations is a core competency of anesthesiology, anesthesiologists are confronted with questions of sedative therapy at the end of life in institutions for specialized palliative care, in intensive care units and intermediate care wards. In recent years a number of guidelines have been published internationally but so far no official guidelines exist in Germany...
May 16, 2018: Der Anaesthesist
https://www.readbyqxmd.com/read/29739781/multiple-risk-factor-control-mortality-and-cardiovascular-events-in-type-2-diabetes-and-chronic-kidney-disease-a-population-based-cohort-study
#3
Shota Hamada, Martin C Gulliford
OBJECTIVES: This study aimed to evaluate the effectiveness of multiple risk factor control (MRFC) at reducing mortality and cardiovascular events in diabetes and chronic kidney disease (CKD) in clinical practice. DESIGN: Population-based cohort study. SETTING: Primary care database in the UK, linked with inpatient and mortality data. PARTICIPANTS: Participants aged 40-79 years with type 2 diabetes and valid serum creatinine measurements, including 11 431 participants with CKD (estimated glomerular filtration rate: eGFR 15-59 mL/min/1...
May 8, 2018: BMJ Open
https://www.readbyqxmd.com/read/29687432/association-of-structured-virtual-visits-for-hypertension-follow-up-in-primary-care-with-blood-pressure-control-and-use-of-clinical-services
#4
David Michael Levine, Ronald F Dixon, Jeffrey A Linder
BACKGROUND: Optimal management of hypertension requires frequent monitoring and follow-up. Novel, pragmatic interventions have the potential to engage patients, maintain blood pressure control, and enhance access to busy primary care practices. "Virtual visits" are structured asynchronous online interactions between a patient and a clinician to extend medical care beyond the initial office visit. OBJECTIVE: To compare blood pressure control and healthcare utilization between patients who received virtual visits compared to usual hypertension care...
April 23, 2018: Journal of General Internal Medicine
https://www.readbyqxmd.com/read/29676667/evaluating-the-clinical-value-of-the-hypoxia-burden-index-in-patients-with-obstructive-sleep-apnea
#5
Fengwei Chen, Kun Chen, Cheng Zhang, Xue Chen, Junjun Huang, Peng Jia, Jing Ma, Jue Zhang, Jing Fang, Guangfa Wang
PURPOSE: We aimed to develop a novel index, the hypoxia burden index (HBI), that reflects the degree and duration of oxygen desaturation, and to determine whether this index is better than the apnea hypopnea-index (AHI) for evaluating obstructive sleep apnea (OSA) and cardiovascular diseases morbidities. METHODS: We retrospectively analyzed 459 adult subjects who underwent overnight polysomnography (PSG) in this study. The HBI was calculated by dividing the total desaturation area of SpO2 below 90% by the TST measured in seconds...
April 20, 2018: Postgraduate Medicine
https://www.readbyqxmd.com/read/29674328/catastrophic-circulatory-collapse-after-inadvertent-subcutaneous-injection-of-treprostinil
#6
John J Radosevich, Mohan Dutt, Jeremy Feldman
PURPOSE: A case of life-threatening cardiovascular collapse after inadvertent subcutaneous injection of undiluted treprostinil is reported. SUMMARY: A 29-year-old, 76-kg woman with group 1 pulmonary arterial hypertension managed with subcutaneous treprostinil infusion arrived at the emergency department (ED) with headache, nausea, vomiting, and a syncopal episode. Her vital signs were stable on presentation. Admission orders were placed, and the appropriate 3-mL syringe containing 7...
April 19, 2018: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29659126/guanfacine-decreases-symptoms-of-cannabis-withdrawal-in-daily-cannabis-smokers
#7
Margaret Haney, Ziva D Cooper, Gillinder Bedi, Evan Herrmann, Sandra D Comer, Stephanie Collins Reed, Richard W Foltin, Frances R Levin
The α2a-adrenergic agonist, lofexidine, reduced cannabis withdrawal-related sleep disruption in the laboratory, but side effects (e.g. fatigue, hypotension) limit its utility as a treatment for cannabis use disorder. This study tested the potential efficacy and tolerability of a daily bedtime administration of the FDA-approved α2a-adrenergic agonist, guanfacine, in a human laboratory model of cannabis use disorder. Daily, nontreatment-seeking cannabis smokers (13M, 2F) completed a within-subject study comprising two 9-day inpatient study phases...
April 16, 2018: Addiction Biology
https://www.readbyqxmd.com/read/29657034/cost-comparison-across-heart-failure-patients-with-reduced-and-preserved-ejection-fractions-analyses-of-inpatient-decompensated-heart-failure-admissions
#8
Natalia Olchanski, Amanda R Vest, Joshua T Cohen, Peter J Neumann, David DeNofrio
BACKGROUND: Heart failure (HF) is the leading cause of inpatient admissions in the US for adults aged over 65 years and accounts for more than $17 billion in Medicare expenditures annually. There are limited published data on factors influencing expenditure and the relationship between cost and hospital length of stay. We sought to describe institutional costs of HF hospitalization, as well as demographic and clinical predictors of higher hospitalization costs in an academic hospital setting...
June 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29579585/resting-heart-rate-in-late-adolescence-and-long-term-risk-of-cardiovascular-disease-in-swedish-men
#9
Martin Lindgren, Josefina Robertson, Martin Adiels, Maria Schaufelberger, Maria Åberg, Kjell Torén, Margda Waern, N David Åberg, Annika Rosengren
AIM: To investigate the association of resting heart rate (RHR) measured in late adolescence with the long term risk of myocardial infarction (MI), ischemic stroke (IS), heart failure (HF), atrial fibrillation (AF), cardiovascular- and all-cause death. METHODS AND RESULTS: We followed a cohort of Swedish men enrolled for conscription in 1968-2005 (n = 1,008,485; mean age = 18.3 years) until December 2014. Outcomes were collected from the national inpatient - (IPR), outpatient - (OPR) and cause of death registries...
May 15, 2018: International Journal of Cardiology
https://www.readbyqxmd.com/read/29575962/inhospital-and-delayed-mortality-after-upper-gastrointestinal-bleeding-an-analysis-of-risk-factors-in-a-prospective-series
#10
Rita Jiménez-Rosales, Francisco Valverde-López, Francisco Vadillo-Calles, Juan Gabriel Martínez-Cara, Mercedes López de Hierro, Eduardo Redondo-Cerezo
BACKGROUND: Detailed analyses of mortality after upper gastrointestinal (GI) bleeding are lacking. Follow-up rarely extends beyond 30 days. AIMS: Our aim was to analyze in-hospital and delayed 6-months mortality, identifying risk factors. METHODS: This was a prospective study on patients with upper GI bleeding over 36 months. Clinical outcomes were in-hospital and delayed-6 month-mortality. RESULTS: Four hundred and forty-none patients were included...
March 26, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29529331/the-relationship-between-pre-operative-hypertension-and-intra-operative-haemodynamic-changes-known-to-be-associated-with-postoperative-morbidity
#11
M Crowther, K van der Spuy, F Roodt, M B Nejthardt, J G Davids, J Roos, E Cloete, T Pretorius, G L Davies, J G van der Walt, C van der Westhuizen, M Flint, J L C Swanevelder, B M Biccard
Hypertension is not consistently associated with postoperative cardiovascular morbidity and is therefore not considered a major peri-operative risk factor. However, hypertension may predispose to peri-operative haemodynamic changes known to be associated with peri-operative morbidity and mortality, such as intra-operative hypotension and tachycardia. The objective of this study was to determine whether pre-operative hypertension was independently associated with haemodynamic changes known to be associated with adverse peri-operative outcomes...
March 12, 2018: Anaesthesia
https://www.readbyqxmd.com/read/29523041/cardiometabolic-risk-factors-physical-activity-and-psychiatric-status-in-patients-in-long-term-psychiatric-inpatient-departments
#12
Petter Andreas Ringen, Ann Faerden, Bjørnar Antonsen, Ragnhild S Falk, Asgeir Mamen, Eline B Rognli, Dag K Solberg, Ole A Andreassen, Egil W Martinsen
PURPOSE: Cardiovascular diseases are a major cause for the markedly reduced life expectancy in people with severe mental illness (SMI). Hospital departments should provide adequate prevention of cardiometabolic risk by optimizing prevention and treatment. Characteristics of cardiometabolic risk factors in inpatients are still not well known. We aimed to describe the status of cardiometabolic risk factors in inpatients with SMI and identify associations with psychiatric status and treatment...
March 9, 2018: Nordic Journal of Psychiatry
https://www.readbyqxmd.com/read/29516615/home-blood-pressure-monitoring-in-a-hypertensive-pregnant-population-cost-minimisation-study
#13
G Xydopoulos, H Perry, E Sheehan, B Thilaganathan, R Fordham, A Khalil
BACKGROUND: Traditional monitoring of blood pressure in hypertensive pregnant women requires frequent visits to the maternity outpatient services. Home blood-pressure monitoring (HBPM) could offer a cost-saving alternative that is acceptable to patients. The main objective of this study was to undertake a health economic analysis of HBPM compared with traditional monitoring in hypertensive pregnant women. METHODS: This was a case-control study. Cases were pregnant women with hypertension who had HBPM with or without the adjunct of a smartphone app, via a specially designed pathway...
March 8, 2018: Ultrasound in Obstetrics & Gynecology
https://www.readbyqxmd.com/read/29511419/comparison-of-the-assessment-of-orthostatic-hypotension-using-peripheral-and-central-blood-pressure-measurements
#14
Kannayiram Alagiakrishnan, Ruojin Bu, Peter Hamilton, Ambikaipakan Senthilselvan, Raj Padwal
Background: Orthostatic hypotension (OH) is associated with falls and cardiovascular events. There is growing evidence that central blood pressure (CBP) is better than peripheral blood pressure (PBP) in predicting adverse outcomes. The objectives of this study were to assess 1) the prevalence of OH identified using PBP and CBP and the levels of agreement, 2) the respective associations between OH and falls and cardiovascular comorbidities, by PBP and CBP, and 3) the association of OH with arterial wall stiffness markers (augmentation pressure (AP) and augmentation index (AI))...
April 2018: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/29509318/a-multivariable-prediction-model-for-mortality-in-individuals-admitted-for-heart-failure
#15
Garrett S Bowen, Michelle S Diop, Lan Jiang, Wen-Chih Wu, James L Rudolph
OBJECTIVES: To derive and validate a 30-day mortality clinical prediction rule for heart failure based on admission data and prior healthcare usage. A secondary objective was to determine the discriminatory function for mortality at 1 and 2 years. DESIGN: Observational cohort. SETTING: Veterans Affairs inpatient medical centers (n=124). PARTICIPANTS: The derivation (2010-12; n=36,021) and validation (2013-15; n=30,364) cohorts included randomly selected veterans admitted for HF exacerbation (mean age 71±11; 98% male)...
March 6, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29471792/inpatient-falls-in-older-adults-a-cohort-study-of-antihypertensive-prescribing-pre-and-post-fall
#16
H M R B Omer, J Hodson, S K Pontefract, U Martin
BACKGROUND: Falls are common during hospital admissions and may occur more frequently in patients who are taking antihypertensive medications, particularly in the context of normal to low blood pressure. The review and adjustment of these medications is an essential aspect of the post-fall assessment and should take place as soon as possible after the fall. Our aim was to investigate whether appropriate post-fall adjustments of antihypertensive medications are routinely made in a large National Health Service (NHS) Trust...
February 23, 2018: BMC Geriatrics
https://www.readbyqxmd.com/read/29466342/early-identification-of-intracranial-hemorrhage-using-a-predictive-nomogram
#17
Frances Chandler, Joyce Kane, Amanda Blackford, Margaux Weinberger, Kavitha Wagner, Ivana Gojo, Melanie Cohen, Colleen Apostol
OBJECTIVES: To identify predictive signs and symptoms occurring in hospitalized adults with hematologic malignancies with intracranial hemorrhage (IH).
. SAMPLE & SETTING: In a National Cancer Institute (NCI)-designated comprehensive cancer center, a retrospective matched case-control design included adult inpatients with hematologic malignancies with (n = 39) and without (n = 39) IH.
. METHODS & VARIABLES: Conditional logistic regression, t test, and Fisher's exact tests were used to assess increased risks for IH and the development of a prognostic nomogram with signs, symptoms, and laboratory values relevant to IH...
March 1, 2018: Oncology Nursing Forum
https://www.readbyqxmd.com/read/29465206/-predictors-of-unfavorable-outcome-in-patients-with-abdominal-sepsis
#18
V V Nazaretyan, V N Lukach, A V Kulikov
OBJECTIVE: The study focuses on identifying predictors of treatment outcome in abdominal sepsis (AS) in humans. SUBJECTS AND METHODS: 70 patients underwent determination of blood pressure, heart rate, SpO , the content of leu- kocytes, albumin, C-reactive protein, fibrinogen and TNF-a in arterial (femoral artery) and venous (subclavian vein) blood. Automatic biochemical analyzer Cobas-Integra 400 ('Roche", Switzerland), the test system Microlab STAR ELISA kit reagents "alpha TNF - ELISA - best" were used during the research...
September 2017: Anesteziologiia i Reanimatologiia
https://www.readbyqxmd.com/read/29457945/factors-that-influence-nurses-assessment-of-patient-acuity-and-response-to-acute-deterioration
#19
Mark Dalton, John Harrison, Anitra Malin, Conan Leavey
BACKGROUND: nurses play a crucial role in the early recognition and management of the deteriorating patient. They are responsible for the care they provide to their patients, part of which is the monitoring of vital signs (blood pressure, pulse, respiratory rate and temperature), which are fundamental in the surveillance of deterioration. The aim of this study was to discover what factors influence how nurses assess patient acuity and their response to acute deterioration. METHODS: a generic qualitative approach was used...
February 22, 2018: British Journal of Nursing: BJN
https://www.readbyqxmd.com/read/29344402/young-asian-men-with-diabetes-have-the-highest-risk-for-acute-coronary-events-retrospective-cohort-analyses
#20
Ansu Basu, Nithya Sukumar, Robert Ej Ryder
Objective: To understand the ethnic differences in coronary heart disease risk among inpatients with diabetes following acute coronary syndrome. Design: Single-centre retrospective cohort-analysis of patients with type II diabetes over a six-year period receiving standard care. Setting: Birmingham, UK. Participants: One thousand and one hundred and five patients with type II diabetes from a multi-ethnic background. Main outcome measures: Odds ratios of coronary heart disease events among three ethnic groups...
January 2018: JRSM Open
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