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https://www.readbyqxmd.com/read/28320201/analysis-of-never-events-following-adult-cardiac-surgical-procedures-in-the-united-states
#1
Michael P Robich, Brianna M Krafcik, Nishant K Shah, Alik Farber, Denis Rybin, Jeffrey J Siracuse
BACKGROUND: This study was conducted to determine the risk factors, nature, and outcomes of "never events" following open adult cardiac surgical procedures. Understanding of these events can reduce their occurrence, and thereby improve patient care, quality metrics, and cost reduction. METHODS: "Never events" for patients included in the Nationwide Inpatient Sample who underwent coronary artery bypass graft, heart valve repair/replacement, or thoracic aneurysm repair between 2003-2011 were documented...
March 16, 2017: Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28303986/assessing-decision-of-inpatient-or-outpatient-care-in-community-acquired-pneumonia-apt-care-study
#2
Saleem Ullah, Javaid Khan, Amanullah Khan, Irfan Hashemy
OBJECTIVE: To estimate the proportion of community-acquired pneumonia patients with disagreement between Confusion, Uraemia, Respiratory rate, Blood pressure, age > 65 years recommendation and physician's decision to hospitalise or not. METHODS: This cross-sectional nation-wide, non-interventional, cross-sectional study was carried out across 10 cities of Pakistan from December 2011 to May 2012, and recruited consenting adult patients with confirmatory diagnosis of community-acquired pneumonia on chest X-ray...
March 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28284202/effects-of-integrated-chronic-care-models-on-hypertension-outcomes-and-spending-a-multi-town-clustered-randomized-trial-in-china
#3
Yuting Zhang, Wenxi Tang, Yan Zhang, Lulu Liu, Liang Zhang
BACKGROUND: Hypertension affects one billion people globally and is one of the leading risk factors for cardiovascular and renal diseases. However, hypertension management remains poor, especially in rural China. METHODS: A clustered randomized controlled trial was conducted in six towns in China's Qianjiang county between 7/2012 and 6/2014, including 5462 hypertension patients above 35 years old. Six towns were randomly assigned to three groups: Group 1 had the integrated care model including a multidisciplinary team and continuous care coordination, Group 2 had both the integrated care model and provider-level financial incentives, and the control group had the usual care...
March 11, 2017: BMC Public Health
https://www.readbyqxmd.com/read/28276719/outdoor-temperature-and-temperature-maintenance-associated-with-blood-pressure-in-438-811-chinese-adults
#4
Shuojia Wang, Minchao Li, Zhengjiang Hua, Chun Ye, Shuying Jiang, Zhaopin Wang, Zhenya Song, Yunxian Yu
OBJECTIVES: The association of temperature maintenance with blood pressure (BP) has not been studied and the association of temperature with season-related BP was not being well understood. The present study aims to be further aware of season-related BP variation in Chinese adults. METHODS: We used decoded data from adults who visited the hospital for health examination from January 2008 to November 2013. Multivariate regression models were used to analyses the association between outdoor temperature and BP...
March 1, 2017: Blood Pressure
https://www.readbyqxmd.com/read/28272012/accuracy-of-the-ankle-brachial-index-in-the-assessment-of-arterial-perfusion-of-heel-pressure-injuries
#5
Amanda Crowell, Andrew J Meyr
BACKGROUND: The evaluation and treatment of heel pressure injuries are a significant and expensive sequela of the aging population. Although the workup of patients with lower extremity tissue loss usually involves an assessment of the arterial blood flow by means of noninvasive vascular testing, the results may be misleading in patients with heel pressure injuries when the ankle-brachial index (ABI) does not provide direct information about perfusion of the rearfoot. The objective of this retrospective, observational investigation was to determine if noninvasive vascular testing provides accurate and reliable results in patients with heel pressure injuries...
February 2017: Wounds: a Compendium of Clinical Research and Practice
https://www.readbyqxmd.com/read/28243581/impact-of-changing-clinical-practices-on-early-blood-gas-analyses-in-very-preterm-infants-and-their-associated-inpatient-outcomes
#6
Hongmei Huang, Po-Yin Cheung, Megan O'Reilly, Sylvia van Os, Anne Lee Solevåg, Khalid Aziz, Georg M Schmölzer
BACKGROUND: Early studies suggest an association of abnormal carbon dioxide (PCO2) or oxygen (PO2) levels with adverse inpatient outcomes in very preterm babies. Recent resuscitation practice changes, such as targeted oxygen therapy, end-expiratory pressure, and rescue surfactant may influence these associations. OBJECTIVE: The aim of this study is to assess the range of the initial partial pressures of PCO2 and PO2 in preterm neonates <33 weeks gestational age after birth and their correlation to inpatient neonatal outcomes...
2017: Frontiers in Pediatrics
https://www.readbyqxmd.com/read/28238106/a-critical-assessment-of-early-warning-score-records-in-168-000-patients
#7
Niels Egholm Pedersen, Lars Simon Rasmussen, John Asger Petersen, Thomas Alexander Gerds, Doris Østergaard, Anne Lippert
The national early warning score (NEWS) is recommended to detect deterioration in hospitalised patients. In 2013, a NEWS-based system was introduced in a hospital service with over 250,000 annual admissions, generating large amounts of NEWS data. The quality of such data has not been described. We critically assessed NEWS data recorded over 12 months. This observational study included NEWS records from adult inpatients hospitalized in the Capital Region of Denmark during 2014. Physiological variables and the use of supplementary oxygen (NEWS variables) were recorded...
February 25, 2017: Journal of Clinical Monitoring and Computing
https://www.readbyqxmd.com/read/28223950/the-motiv-heart-study-a-prospective-randomized-single-blind-pilot-study-of-brief-strategic-therapy-and-motivational-interviewing-among-cardiac-rehabilitation-patients
#8
Giada Pietrabissa, Gian Mauro Manzoni, Alessandro Rossi, Gianluca Castelnuovo
Background: Psychological distress, biomedical parameters, and unhealthy lifestyles contribute to a poorer prognosis for cardiac disease. Public health's challenge is to motivate patients to utilize self-care. Objective: This prospective, randomized, single-blind pilot study aimed at testing the incremental efficacy of Brief Strategic Therapy (BST) combined with Motivational Interviewing (MI) in improving selected biomedical and psychological outcomes over and beyond those of the stand-alone BST in a residential Cardiac Rehabilitation (CR) program...
2017: Frontiers in Psychology
https://www.readbyqxmd.com/read/28214752/metabolic-syndrome-and-cardiovascular-risk-among-institutionalized-patients-with-schizophrenia-receiving-long-term-tertiary-care
#9
Lee Seng Esmond Seow, Siow Ann Chong, Peizhi Wang, Saleha Shafie, Hui Lin Ong, Mythily Subramaniam
BACKGROUND: Metabolic syndrome (MetS) and cardiovascular risk are highly prevalent among individuals with schizophrenia. This study aimed to determine the cardiometabolic profile and the associated risk factors in a group of institutionalized patients with schizophrenia or schizoaffective disorder receiving prolonged hospital care in the only tertiary psychiatric institution in Singapore. METHODS: Patients residing in long stay wards who were hospitalized for a minimum period of 1year were recruited...
February 2, 2017: Comprehensive Psychiatry
https://www.readbyqxmd.com/read/28213385/effectiveness-of-acarbose-in-treating-elderly-patients-with-diabetes-with-postprandial-hypotension
#10
Jie Zhang, Lixin Guo
: Postprandial hypotension (PPH) is a common condition that occurs primarily in elderly patients with type 2 diabetes mellitus (T2DM). This study aimed to assess the effectiveness of acarbose for PPH; it also investigated possible mechanisms behind PPH development. This single-blind, randomized controlled trial included 91 elderly patients with T2DM, aged between 60 and 80 years, who were inpatients at Beijing Hospital between March 2012 and November 2014. The patients were included into one of three groups: Group A, patients with T2DM without PPH; Group B, patients with T2DM with PPH receiving placebo; and Group C, patients with T2DM with PPH receiving acarbose...
February 17, 2017: Journal of Investigative Medicine: the Official Publication of the American Federation for Clinical Research
https://www.readbyqxmd.com/read/28187154/comparison-of-different-inspiratory-triggering-settings-in-automated-ventilators-during-cardiopulmonary-resuscitation-in-a-porcine-model
#11
Dingyu Tan, Jun Xu, Shihuan Shao, Yangyang Fu, Feng Sun, Yazhi Zhang, Yingying Hu, Joseph Walline, Huadong Zhu, Xuezhong Yu
BACKGROUND: Mechanical ventilation via automated in-hospital ventilators is quite common during cardiopulmonary resuscitation. It is not known whether different inspiratory triggering sensitivity settings of ordinary ventilators have different effects on actual ventilation, gas exchange and hemodynamics during resuscitation. METHODS: 18 pigs enrolled in this study were anaesthetized and intubated. Continuous chest compressions and mechanical ventilation (volume-controlled mode, 100% O2, respiratory rate 10/min, and tidal volumes 10ml/kg) were performed after 3 minutes of ventricular fibrillation...
2017: PloS One
https://www.readbyqxmd.com/read/28167327/physical-activity-ameliorates-the-association-between-sedentary-behavior-and-cardiometabolic-risk-among-inpatients-with-schizophrenia-a-comparison-versus-controls-using-accelerometry
#12
Brendon Stubbs, Li-Jung Chen, Ming-Shun Chung, Po-Wen Ku
OBJECTIVE: A lack of clarity exists regarding the relationship between objectively measured physical activity (PA) and sedentary behavior (SB) and cardiometabolic outcomes in people with schizophrenia. We conducted a large study investigating the independent relationships of PA and SB among inpatients with schizophrenia versus healthy controls (HCs). METHODS: A cross sectional study including 199 inpatients with schizophrenia (mean age 44.0years, mean illness duration 23...
January 20, 2017: Comprehensive Psychiatry
https://www.readbyqxmd.com/read/28158876/predictors-of-the-need-for-therapeutic-intervention-in-older-adult-patients-with-a-nonvariceal-gastrointestinal-bleed
#13
Khalid Abusaada, Xiaoping He, Fnu Asad-Ur-Rahman, Umair Majeed, Evgeny Idrisov, Sameen Khalid, Xiang Zhu, Vladimir Pech, George Everett
OBJECTIVE: Gastrointestinal bleeding (GIB) is a common cause of hospitalization in the older adult population. The aim of the study was to identify factors that are associated with the need for a therapeutic intervention in patients older than 65 years with nonvariceal GIB. METHODS: This is a retrospective cohort study of older adult patients admitted to a tertiary care center between 2009 and 2011 with nonvariceal GIB. The primary outcome was a composite endpoint of inpatient mortality or need for an endoscopic, surgical, or radiologic procedure to control the bleed or to treat the underlying source of the bleed...
February 2017: Southern Medical Journal
https://www.readbyqxmd.com/read/28151403/cardiovascular-health-and-healthcare-utilization-and-expenditures-among-medicare-beneficiaries-the-reasons-for-geographic-and-racial-differences-in-stroke-regards-study
#14
Kristal J Aaron, Lisandro D Colantonio, Luqin Deng, Suzanne E Judd, Julie L Locher, Monika M Safford, Mary Cushman, Meredith L Kilgore, David J Becker, Paul Muntner
BACKGROUND: Better cardiovascular health is associated with lower cardiovascular disease risk. METHODS AND RESULTS: We determined the association between cardiovascular health and healthcare utilization and expenditures in the REasons for Geographic And Racial Differences in Stroke (REGARDS) study. We included 6262 participants ≥65 years with Medicare fee-for-service coverage for the year after their baseline study visit in 2003-2007. Cardiovascular health at baseline was assessed using the American Heart Association's Life's Simple 7 (LS7) metric, which includes 7 factors: cigarette smoking, physical activity, diet, body mass index, blood pressure, cholesterol, and glucose...
February 1, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28122873/rising-stakes-for-healthcare-associated-infection-prevention-implications-for-the-clinical-microbiology-laboratory-revised
#15
Daniel J Diekema
Healthcare associated infection (HAI) rates are subject to public reporting, and are linked to hospital reimbursement from the Centers for Medicare and Medicaid Services (CMS). The increasing pressure to lower HAI rates comes at a time when advances in the clinical microbiology laboratory (CML) provide more precise and sensitive tests, altering HAI detection in ways that may increase reported HAI rates. I review how changing CML practices can impact HAI rates, and how the financial implications of HAI metrics may produce pressure to change diagnostic testing practices...
January 25, 2017: Journal of Clinical Microbiology
https://www.readbyqxmd.com/read/28110990/quick-sofa-scores-predict-mortality-in-adult-emergency-department-patients-with-and-without-suspected-infection
#16
Adam J Singer, Jennifer Ng, Henry C Thode, Rory Spiegel, Scott Weingart
STUDY OBJECTIVE: The Quick Sequential Organ Failure Assessment (qSOFA) score (composed of respiratory rate ≥22 breaths/min, systolic blood pressure ≤100 mm Hg, and altered mental status) may identify patients with infection who are at risk of complications. We determined the association between qSOFA scores and outcomes in adult emergency department (ED) patients with and without suspected infection. METHODS: We performed a single-site, retrospective review of adult ED patients between January 2014 and March 2015...
January 19, 2017: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/28105372/association-between-central-blood-pressure-arterial-stiffness-and-mild-cognitive-impairment
#17
R Suleman, R Padwal, P Hamilton, A Senthilselvan, K Alagiakrishnan
BACKGROUND: To determine the relationship between central blood pressure (CBP) indices and mild cognitive impairment (MCI) in adults over the age of 50. METHODS: A cross-sectional study conducted using a non-invasive SphygmoCor XCEL device. CBP indices and brachial blood pressure were measured in 50 inpatients and outpatients. MCI was assessed using the Montreal Cognitive Assessment (MoCA) instrument and by the European Consortium Criteria (ECC). RESULTS: Seventy-six percent of subjects had hypertension, and 52% were diagnosed as having MCI using the ECC...
2017: Clinical Hypertension
https://www.readbyqxmd.com/read/28074349/second-generation-antipsychotic-utilization-and-metabolic-parameter-monitoring-in-an-inpatient-pediatric-population-a-retrospective-analysis
#18
Valerie D Nolt, Alexandra Victoria Kibler, G Lucy Wilkening, Tanya J Fabian
BACKGROUND: Second-generation antipsychotics (SGAs) are prescribed for a variety of indications and are strongly associated with adverse metabolic effects. Studies of pediatric outpatients have revealed several deficiencies in monitoring practices for adverse effects associated with SGAs. OBJECTIVE: Our objective was to characterize SGA prescribing and metabolic parameter monitoring (MPM) in an inpatient pediatric population. METHODS: Patients aged <18 years and discharged on SGA treatment between 1 November 2013 and 30 April 2014 from an inpatient psychiatric institution in Pittsburgh, PA, USA were included...
April 2017: Paediatric Drugs
https://www.readbyqxmd.com/read/28039870/outcomes-of-treated-hypertension-at-age-80-and-older-cohort-analysis-of-79-376-individuals
#19
João Delgado, Jane A H Masoli, Kirsty Bowman, W David Strain, George A Kuchel, Kate Walters, Louise Lafortune, Carol Brayne, David Melzer, Alessandro Ble
OBJECTIVES: To estimate outcomes according to attained blood pressure (BP) in the oldest adults treated for hypertension in routine family practice. DESIGN: Cohort analysis of primary care inpatient and death certificate data for individuals with hypertension. SETTING: Primary care practices in England (Clinical Practice Research Datalink). PARTICIPANTS: Individuals aged 80 and older taking antihypertensive medication and free of dementia, cancer, coronary heart disease, stroke, heart failure, and end-stage renal failure at baseline...
December 30, 2016: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28012492/guidelines-concordant-empiric-antimicrobial-therapy-and-mortality-in-patients-with-severe-community-acquired-pneumonia-requiring-mechanical-ventilation
#20
Yukiyo Sakamoto, Yasuhiro Yamauchi, Hideo Yasunaga, Hideyuki Takeshima, Wakae Hasegawa, Taisuke Jo, Hiroki Matsui, Kiyohide Fushimi, Takahide Nagase
BACKGROUND: Community-acquired pneumonia (CAP) has high morbidity and mortality among adults. Several clinical guidelines recommend prompt administration of combined antimicrobial therapy. However, the association between guidelines concordance and mortality in patients with severe pneumonia remains unclear. The present study aimed to examine the impact of guidelines-concordant empiric antimicrobial therapy on 7-day mortality in patients with extremely severe pneumonia who required mechanical ventilation at admission, using a nationwide inpatient database in Japan...
January 2017: Respiratory Investigation
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