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https://www.readbyqxmd.com/read/29164350/predictors-of-partial-hospital-readmission-for-young-children-with-oppositional-defiant-disorder
#1
John R Boekamp, Richard T Liu, Sarah E Martin, Lauren R Mernick, Mia DeMarco, Anthony Spirito
This study aimed to: (1) examine rates of readmission among young children with oppositional defiant disorder (ODD) following discharge from a psychiatric partial hospital treatment program, and (2) examine child factors (i.e., age, sex, co-occurring diagnoses, suicidality) and family factors (i.e., parental depression, stress) as prospective predictors of readmission. Participants were 261 children (ages 3-7 years) who entered the study at the time of their initial program admission and who met DSM-IV criteria for ODD...
November 21, 2017: Child Psychiatry and Human Development
https://www.readbyqxmd.com/read/29157786/the-seasonal-variability-of-surgical-site-infections-in-knee-and-hip-arthroplasty
#2
Chris A Anthony, Ryan A Peterson, Daniel K Sewell, Linnea A Polgreen, Jacob E Simmering, John J Callaghan, Philip M Polgreen
BACKGROUND: Surgical site infections (SSIs) after total knee (TKA) and total hip (THA) arthroplasty are devastating to patients and costly to healthcare systems. The purpose of this study is to investigate the seasonality of TKA and THA SSIs at a national level. METHODS: All data were extracted from the National Readmission Database for 2013 and 2014. Patients were included if they had undergone TKA or THA. We modeled the odds of having a primary diagnosis of SSI as a function of discharge date by month, payer status, hospital size, and various patient co-morbidities...
November 1, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29157740/unplanned-readmissions-after-open-thoracoabdominal-aortic-aneurysm-repair
#3
Darrell Wu, Matt D Price, Hiruni S Amarasekara, Susan Y Green, Sandra J Woodside, Adam Tullos, Qianzi Zhang, Joseph S Coselli, Scott A LeMaire
BACKGROUND: Although reducing the incidence of unplanned readmission after thoracoabdominal aortic aneurysm (TAAA) repair represents an important opportunity to improve outcomes, predictors of readmissions are not known. We sought to characterize and identify factors associated with unplanned readmission after discharge in survivors of open TAAA repair. METHODS: Through prospective phone contact and retrospective record review, we determined the frequency and characteristics of unplanned readmissions within 30 days of discharge in 363 patients who were discharged after open TAAA repair...
November 17, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/29155440/severe-hypoglycemia-caused-by-lenalidomide
#4
Daniel J Przybylski, Ruemu Birhiray, David J Reeves
Lenalidomide is commonly used for multiple myeloma as either induction or maintenance therapy. The agent is associated with a host of adverse effects, but hypoglycemia has only been reported in one phase I trial in patients with solid tumors. We describe a 74-year-old woman who experienced grade 3 hypoglycemia (blood glucose level 35 mg/dL) likely related to lenalidomide. Her medical history was significant for refractory myeloma and type 2 diabetes mellitus. Lenalidomide was started as maintenance therapy following autologous bone marrow transplantation...
November 20, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29153941/the-impact-of-readmission-hospital-on-failure-to-rescue-rates-following-major-urologic-cancer-surgery
#5
Jasmir G Nayak, Sarah K Holt, Jonathan L Wright, Matthew Mossanen, Atreya Dash, John L Gore
PURPOSE: Patients readmitted to secondary hospitals rather than the primary hospital where their surgery took place may be at risk for poorer outcomes. We sought to evaluate the effect of site of readmission on failure-to-rescue complication rates following urologic cancer surgery. MATERIALS AND METHODS: Retrospective review of major urologic cancer surgeries in the Washington State Comprehensive Hospital Abstract Reporting System between 1998 and 2013. Failure-to-rescue (FTR) rates, defined as inpatient death after a complication requiring hospital readmission, were compared between patients readmitted to their primary hospital with those readmitted to a secondary hospital...
November 16, 2017: Urologic Oncology
https://www.readbyqxmd.com/read/29152760/the-national-landscape-of-unplanned-30-day-readmissions-after-total-laryngectomy
#6
Rocco Ferrandino, Jonathan Garneau, Scott Roof, Caitlin Pacheco, Priti Poojary, Aparna Saha, Kinsuk Chauhan, Brett Miles
OBJECTIVES/HYPOTHESIS: Examine rates of readmission after total laryngectomy and determine primary etiologies, timing, and risk factors for unplanned readmission. STUDY DESIGN: Retrospective cohort study. METHODS: The Nationwide Readmissions Database was queried for patients who underwent total laryngectomy between January 2013 and November 2013. Patient-, procedure-, admission-, and institution-level characteristics were compared for patients with and without unplanned 30-day readmission...
November 20, 2017: Laryngoscope
https://www.readbyqxmd.com/read/29146680/the-association-between-patient-experience-factors-and-likelihood-of-30-day-readmission-a-prospective-cohort-study
#7
Jocelyn Carter, Charlotte Ward, Deborah Wexler, Karen Donelan
OBJECTIVE: Hospital readmissions comprise nearly a third of US healthcare expenditures. Fifteen to 20 per cent of this spending is considered to be potentially preventable. Risk prediction models have suboptimal accuracy and typically exclude patient experience data. No studies have explored patient perceptions of the likelihood of readmission during index admission. Our objective was to examine associations between patient perceptions of care during index hospital admission and 30-day readmission...
November 16, 2017: BMJ Quality & Safety
https://www.readbyqxmd.com/read/29146432/predictors-of-hospital-length-of-stay-and-30-day-readmission-in-cervical-spondylotic-myelopathy-patients-an-analysis-of-3057-patients-using-the-acs-nsqip-database
#8
Peter G Passias, Cyrus M Jalai, Nancy Worley, Shaleen Vira, Saqib Hasan, Samantha R Horn, Frank A Segreto, Cole A Bortz, Andrew P White, Michael Gerling, Virginie LaFage, Thomas Errico
BACKGROUND: Hospital length of stay (LOS), 30-day readmission rate, and other metrics are increasingly being used to evaluate quality of surgical care. The factors most relevant to cervical spondylotic myelopathy (CSM) are not yet established. OBJECTIVE: To identify peri-operative factors associated with extended LOS and/or 30-day readmission following elective surgery for CSM. METHODS: Surgical CSM patients at institutions represented by the American-College-of-Surgeons-National-Surgical-Quality-Improvement-Program (ACS-NSQIP) from 2010-2012 were included...
November 13, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29143480/telephone-discharge-support-for-frail-vulnerable-older-people-discharged-from-hospital-impact-on-readmission-rates-participant-and-general-practitioner-feedback
#9
Claire P Heppenstall, Hugh C Hanger, Timothy J Wilkinson, Michelle Dhanak
OBJECTIVE: To assess the use and acceptability to older participants and general practitioners (GPs) of telephone support postdischarge to reduce readmissions. METHODS: A prospective cohort study of older people after discharge from a specialist geriatric unit, and comparison with a previous cohort. Telephone follow-up calls were made fortnightly for three months. Structured questionnaires were used to obtain feedback from participants and GPs. RESULTS: Readmission rates were high, 40%, despite the intervention...
November 15, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/29139356/-persistent-trophoblast-tissue-after-salpingectomy
#10
EDITORIAL
Louise Stig Hornstrup, Bjarke Lunde Sørensen, Vicky Jenny-Rebecka Wetterstrand
We present a case of persistent trophoblast tissue (PT) five weeks after salpingectomy for tubal pregnancy. The fallopian tube-sparing method (salpingotomy) has a greater risk of PT than removal of the whole fallopian tube (salpingectomy) has. A 32-year-old woman was treated with salpingectomy on suspicion of a bleeding ectopic pregnancy and was readmitted due to PT. There is no evidence for measuring the human chorionic gonadotropin (hCG) level as routine follow-up after salpingectomy, but it is important to be aware of the risk of PT and if in doubt measure the levels of hCG...
November 13, 2017: Ugeskrift for Laeger
https://www.readbyqxmd.com/read/29132400/hospitalization-causes-and-outcomes-in-hiv-patients-in-the-late-antiretroviral-era-in-colombia
#11
María Fernanda Álvarez Barreneche, Carlos Andrés Restrepo Castro, Alicia Hidrón Botero, Juan Pablo Villa Franco, Ivan Mauricio Trompa Romero, Laura Restrepo Carvajal, Alejandro Eusse García, Adriana Ocampo Mesa, Lina María Echeverri Toro, Glenys Patricia Porras Fernández de Castro, Jaime Mauricio Ramírez Rivera, Carlos Andrés Agudelo Restrepo
BACKGROUND: Antiretroviral therapy (ART) has modified the natural history of HIV-infection: the incidence of opportunistic infections (OIs) has decreased and mortality associated to HIV has improved dramatically. The reasons for hospitalization have changed; OIs are no longer the most common reason for admission. This study describes the patient population, admission diagnosis and hospital course of HIV patients in Colombia in the ART era. METHODS: Patients admitted with HIV/AIDS at six hospitals in Medellin, Colombia between August 1, 2014 and July 31, 2015 were included...
November 13, 2017: AIDS Research and Therapy
https://www.readbyqxmd.com/read/29131092/value-of-intraoperative-parathyroid-hormone-assay-during-parathyroidectomy-in-dialysis-and-renal-transplant-patients-with-secondary-and-tertiary-hyperparathyroidism
#12
Amr El-Husseini, Kevin Wang, Annick Edon, David Saxon, Florence Lima, David Sloan, B Peter Sawaya
BACKGROUND: In dialysis and renal transplant patients with secondary and tertiary hyperparathyroidism (HPT), the value of intraoperative parathyroid hormone (ioPTH) during parathyroidectomy (PTX) and its association with long-term PTH levels are unknown. The present study aims at evaluating the relationship of ioPTH with long-term PTH levels post-PTX in dialysis and renal transplant patients in a single-center study. METHODS: The ioPTH was measured in 57 dialysis patients (33 females and 24 males) and 18 renal transplant recipients (12 males and 6 females) who underwent PTX from 2005 to 2015 for refractory HPT...
November 9, 2017: Nephron
https://www.readbyqxmd.com/read/29128386/a-pilot-study-of-endoscopically-inserted-biodegradable-biliary-stents-in-the-treatment-of-benign-biliary-strictures-and-cystic-duct-leaks
#13
Antti Siiki, Irina Rinta-Kiikka, Juhani Sand, Johanna Laukkarinen
BACKGROUND AND AIMS: Self-expanding biodegradable biliary stents (BDBSs) have recently become available for use in endoscopic retrograde cholangiography (ERC). The aim was to evaluate the effectiveness and safety of novel BDBS in iatrogenic cystic duct leaks and benign biliary strictures (BBSs). MATERIALS AND METHODS: Patients providing informed consent were recruited for the prospective study. Braided self-expanding poly-dioxanone BDBSs were inserted in ERC during the period 2012 to 2016...
November 8, 2017: Gastrointestinal Endoscopy
https://www.readbyqxmd.com/read/29121845/improving-outcomes-for-lower-extremity-amputations-using-intraoperative-fluorescent-angiography-to-predict-flap-viability
#14
Andrew E Yang, Charles A Hartranft, Alisha Reiss, Charles R Holden
OBJECTIVES: Nearly 25% of vascular surgery patients operated on for peripheral vascular disease are readmitted within 30 days. Development of adjuncts to minimize wound complications remains an area of great interest. Here, we present our experience with intraoperative fluorescent angiography (IFA) as a tool to predict skin flap viability following lower extremity amputations (LEAs). METHODS: Experience with IFA using indocyanine green (ICG) dye was reviewed retrospectively at a single institution...
January 1, 2017: Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/29118704/spontaneous-remission-of-severe-systemic-langerhans-cell-histiocytosis-with-bladder-involvement-a-case-study
#15
Isotta M Magaton, Alexandar Tzankov, Fatime Krasniqi, Christof Rottenburger, Rosanna Zanetti-Daellenbach, Peter Grendelmeier, Viola Heinzelmann-Schwarz, Michael Mayr, Fabienne D Schwab
Background: The clinical presentation of Langerhans cell histiocytosis (LCH) is heterogeneous ranging from single-organ involvement to systemic disease causing substantial morbidity and mortality. We describe an unusual course of severe multisystem LCH with spontaneous remission. Case Presentation: We report on a 45-year-old Caucasian woman with cervical cancer, FIGO stage IVB. Five months after the end of combined radiochemotherapy and brachytherapy, the patient was readmitted because of severe dysuria...
September 2017: Case Reports in Oncology
https://www.readbyqxmd.com/read/29116542/the-outcomes-and-risk-factors-of-early-readmission-in-patients-with-intestinal-beh%C3%A3-et-s-disease
#16
Yong Eun Park, Jae Hee Cheon, Yehyun Park, Soo Jung Park, Tae Il Kim, Won Ho Kim
Hospital readmission rate is an integral quality of care measurement for hospitalized patients which is unknown for intestinal Behçet's disease cases. The purpose of this study was to investigate the risk factors and outcomes for patients readmitted early with intestinal Behçet's disease. We retrospectively reviewed patients with intestinal Behçet's disease who were readmitted to our hospital between 2005 and 2016. We then analyzed the risk factors and outcomes for early readmission within 3 months. Of the 204 patients who were readmitted, 103 patients (50...
November 7, 2017: Clinical Rheumatology
https://www.readbyqxmd.com/read/29116394/a-prospective-randomized-pilot-study-evaluating-an-eras-protocol-versus-a-standard-protocol-for-patients-treated-with-radical-cystectomy-and-urinary-diversion-for-bladder-cancer
#17
Sebastian Karl Frees, Jonathan Aning, Peter Black, Werner Struss, Robert Bell, Claudia Chavez-Munoz, Martin Gleave, Alan I So
PURPOSE: There is a lack of evidence demonstrating the benefits of using enhanced recovery after surgery protocols (ERAS). Here, we propose to use a randomized clinical pilot study to demonstrate the benefits and feasibility of implementing ERAS versus standard protocols (SP) in patients undergoing radical cystectomy (RC) and urinary diversion. METHODS: 27 consecutive patients undergoing RC were included in the study. 12 patients were prospectively randomized to follow an ERAS protocol and 15 patients followed an SP...
November 7, 2017: World Journal of Urology
https://www.readbyqxmd.com/read/29115709/safety-of-discharge-for-children-with-cancer-and-febrile-neutropenia-off-antibiotics-using-absolute-neutrophil-count-threshold-values-as-a-surrogate-marker-for-adequate-bone-marrow-recovery
#18
Matthew E Campbell, Debra L Friedman, Daniel E Dulek, Zhiguo Zhao, Yi Huang, Adam J Esbenshade
BACKGROUND: Febrile neutropenia (F&N) is common among pediatric oncology patients. However, there is a lack of clarity regarding parameters whereby such patients have demonstrated adequate bone marrow recovery for hospital discharge and empiric antibiotic discontinuation. PROCEDURE: A retrospective review was performed for 350 episodes of F&N occurring at a single institution between 2007 and 2012 in pediatric oncology patients who were afebrile for 24 hr and had no bacterial source identified...
November 8, 2017: Pediatric Blood & Cancer
https://www.readbyqxmd.com/read/29114979/weight-cycling-in-adults-with-severe-obesity-a-longitudinal-study
#19
Marwan El Ghoch, Simona Calugi, Riccardo Dalle Grave
AIM: Although weight cycling is a common phenomenon in treatment-seeking patients with obesity, its consequences on health outcomes have not yet been completely clarified. We therefore aimed to investigate the effect of one cycle of intentional weight loss and regain on energy expenditure, body composition, cardiovascular risk factors and psychosocial variables in patients with severe obesity. METHODS: Clinical and psychosocial variables were measured in 38 adult patients with severe obesity (body mass index (BMI): 43...
November 8, 2017: Nutrition & Dietetics: the Journal of the Dietitians Association of Australia
https://www.readbyqxmd.com/read/29112078/survival-outcomes-following-the-use-of-extracorporeal-membrane-oxygenation-as-a-rescue-technology-in-critically-ill-patients-results-from-pennsylvania-2007-2015
#20
Marco D Huesch, Andrew Foy, Christoph Brehm
OBJECTIVE: To examine real-world outcomes of survival, length of stay, and discharge destination, among all adult extracorporeal membrane oxygenation admissions in one state over nearly a decade. DESIGN: Retrospective analysis of administrative discharge data. SETTING: State-wide administrative discharge data from Pennsylvania between 2007 and 2015. PATIENTS: All 2,948 consecutive patients billed under a Diagnosis-Related Grouper 3 grouper and in whom a procedural code for extracorporeal membrane oxygenation was present, admitted between the beginning of 2007 and the end of 2015 to hospitals regulated by the state of Pennsylvania...
November 3, 2017: Critical Care Medicine
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