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Delays in care

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https://www.readbyqxmd.com/read/28535285/delayed-hospital-discharges-of-older-patients-a-systematic-review-on-prevalence-and-costs
#1
Filipa Landeiro, Kenny Roberts, Alastair Mcintosh Gray, José Leal
Purpose of the Study: To determine the prevalence of delayed discharges of elderly inpatients and associated costs. Design and Methods: We searched Medline, Embase, Global Health, CAB Abstracts, Econlit, Web of Knowledge, EBSCO - CINAHL, The Cochrane Library, Health Management Information Consortium, and SCIE - Social Care Online for evidence published between 1990 and 2015 on number of days or proportion of delayed discharges for elderly inpatients in acute hospitals...
May 23, 2017: Gerontologist
https://www.readbyqxmd.com/read/28534471/management-of-acetabular-fractures-in-the-geriatric-patient
#2
Marc Hanschen, Sebastian Pesch, Stefan Huber-Wagner, Peter Biberthaler
INTRODUCTION: Open reduction and internal fixation (ORIF) is standard care for most acetabular fractures. With increasing numbers of acetabular fractures in the elderly, the risk of revision surgery and conversion to total hip replacement (THR) is increasing. Alarmingly, about 20-25% of acetabular fractures in the elderly following ORIF needed revision and conversion to delayed THR. METHODS: Recently, prognostic factors have been identified, which correlate with an increased risk of worse outcomes following ORIF of acetabular fractures in the elderly patient...
2017: SICOT-J
https://www.readbyqxmd.com/read/28534346/the-use-of-inexpensive-broad-spectrum-lower-toxicity-therapeutics-in-chronic-lymphocytic-leukemia
#3
Goran Marjanovic
The use of new and highly efficient targeted therapies for chronic lymphocytic leukemia (CLL) is costly and out of reach for many health care systems. On the other hand, in recent years, few inexpensive, broad-spectrum low-toxicity therapeutics have proven to be effective both in the preclinical and clinical settings. In early-stage CLL, the use of 2000 mg of epigallocatechin-3-gallate (EGCG) from the green tea extract twice a day was able to reduce the absolute leukocyte count. Supplementation of >2000 IU/day of Vitamin D in early low-risk CLL patients is able to delay disease progression and postpone the moment of initiation of the first treatment...
March 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28533847/predictors-of-delayed-antenatal-care-anc-visits-in-nigeria-secondary-analysis-of-2013-nigeria-demographic-and-health-survey-ndhs
#4
Alhaji Abubakar Aliyu, Tukur Dahiru
INTRODUCTION: Antenatal Care (ANC) is an important component of maternal health and covers a wide range of activities with huge potential benefits for positive pregnancy out comes. However, large proportions of women do initiate ANC early resulting in adverse consequences. METHODS: The study utilized the nationally-representative sample of women of reproductive age interviewed during the 2013 Nigeria DHS. Analysis was restricted to 20, 467 women aged 15-49 years who had a live birth in the five-year period prior to the survey...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28532910/impact-of-elderly-age-on-complications-and-clinical-outcomes-following-anterior-lumbar-interbody-fusion-surgery
#5
Kevin Phan, Vignesh Ramachandran, Tommy Tran, Steven Phan, Prashanth J Rao, Ralph J Mobbs
BACKGROUND: Anterior Lumbar Interbody Fusion (ALIF) is a surgical technique used to treat patients with a variety of lumbar pathologies. Identification of risk factors leading to complication following ALIF surgery may allow surgeons to better judge candidacy and optimize care for high-risk patients. METHODS: A retrospective analysis was conducted on a prospectively collected database of 137 patients who all underwent ALIF surgery by a single primary spine surgeon...
May 19, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28532576/-tobacco-and-plastic-surgery-an-absolute-contraindication
#6
C Matusiak, A De Runz, H Maschino, M Brix, E Simon, F Claudot
INTRODUCTION: Smoking increases perioperative risk regarding wound healing, infection rate and failure of microsurgical procedures. There is no present consensus about plastic and aesthetic surgical indications concerning smoking patients. The aim of our study is to analyze French plastic surgeons practices concerning smokers. METHOD: A questionnaire was send by e-mail to French plastic surgeons in order to evaluate their own operative indications: patient information about smoking dangers, pre- and postoperative delay of smoking cessation, type of intervention carried out, smoking cessation supports, use of screening test and smoking limit associated to surgery refusing were studied...
May 19, 2017: Annales de Chirurgie Plastique et Esthétique
https://www.readbyqxmd.com/read/28532470/health-care-professionals-attitudes-towards-evidence-based-medicine-in-the-workers-compensation-setting-a-cohort-study
#7
Nieke A Elbers, Robin Chase, Ashley Craig, Lyn Guy, Ian A Harris, James W Middleton, Michael K Nicholas, Trudy Rebbeck, John Walsh, Simon Willcock, Keri Lockwood, Ian D Cameron
BACKGROUND: Problems may arise during the approval process of treatment after a compensable work injury, which include excess paperwork, delays in approving services, disputes, and allegations of over-servicing. This is perceived as undesirable for injured people, health care professionals and claims managers, and costly to the health care system, compensation system, workplaces and society. Introducing an Evidence Based Medicine (EBM) decision tool in the workers' compensation system could provide a partial solution, by reducing uncertainty about effective treatment...
May 22, 2017: BMC Medical Informatics and Decision Making
https://www.readbyqxmd.com/read/28532285/utility-of-transient-elastography-in-estimating-hepatic-iron-concentration-in-comparison-to-magnetic-resonance-imaging-in-patients-who-are-transfusion-dependent-a-canadian-center-experience
#8
George Ou, Hin Hin Ko, Pari Tiwari, Navdeep Sandhu, Cherry Galorport, Terry Lee, Hatoon Ezzat
Transfusion-dependent hereditary anemias such as β-thalassemia (β-thal), predispose patients to iron overload and its numerous clinical sequelae. Accurate assessment of overall iron status and prompt initiation of chelation therapy to prevent irreversible end-organ damage can be achieved using magnetic resonance imaging (MRI) to measure liver iron concentration (LIC) as a surrogate marker of total body iron; however, its access may be associated with long wait times and delay in treatment. We report an observational cohort study at a single tertiary care center assessing the theoretical role of transient elastography (TE), which measures liver stiffness, in estimating LIC compared to other established diagnostic measures...
January 2017: Hemoglobin
https://www.readbyqxmd.com/read/28531328/factors-associated-with-compliance-to-aha-acc-performance-measures-in-a-myocardial-infarction-system-of-care-in-brazil
#9
Maria Letícia L Lana, Andrea Z Beaton, Luisa C C Brant, Isadora C R S Bozzi, Osias de Magalhães, Luiz Ricardo de A Castro, Francisco César T da Silva Júnior, José Luiz P da Silva, Antonio Luiz P Ribeiro, Bruno R Nascimento
Objective: To evaluate compliance with American Heart Association/American College of Cardiology (AHA/ACC) performance measures for adults with acute myocardial infarction (AMI) and to investigate the factors associated with compliance, in an AMI System of Care in Brazil. Design: Observational longitudinal study. Setting: A high-complexity University Hospital, part of the AMI System of Care implemented in Belo Horizonte, Brazil, in 2010. Participants: Of note, 1129 patients with ST-elevation myocardial infarction (STEMI) and non-ST-elevation myocardial infarction (NSTEMI) admitted to a single center over 36 months (between 2011 and 2014)...
May 20, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28530851/chondral-injuries-and-irreparable-meniscal-tears-among-adolescents-with-anterior-cruciate-ligament-or-meniscal-tears-are-more-common-in-patients-with-public-insurance
#10
Ariel A Williams, Nickolas S Mancini, Matthew J Solomito, Carl W Nissen, Matthew D Milewski
BACKGROUND: Access to health care services is a critical component of health care reform and may differ among patients with different types of insurance. Hypothesis/Purpose: The purpose was to compare adolescents with private and public insurance undergoing surgery for anterior cruciate ligament (ACL) and/or meniscal tears. We hypothesized that patients with public insurance would have a delayed presentation from the time of injury and therefore would have a higher incidence of chondral injuries and irreparable meniscal tears and lower preoperative International Knee Documentation Committee (IKDC) scores than patients with private insurance...
May 1, 2017: American Journal of Sports Medicine
https://www.readbyqxmd.com/read/28530520/cardiovascular-disease-and-gout-real-world-experience-evaluating-patient-characteristics-treatment-patterns-and-health-care-utilization
#11
Michael H Pillinger, Sripal Bangalore, Alyssa B Klein, Scott Baumgartner, Robert Morlock
BACKGROUND: Gout, hyperuricemia, and cardiovascular disease (CVD) are prevalent conditions in the United States, and while they share common risk factors such as obesity, hypertension, hypercholesterolemia, and type 2 diabetes mellitus, relatively little is known about what patient and disease characteristics may link CVD with hyperuricemia and gout and how the presence of both diseases affects management decisions differently than for patients with gout alone. OBJECTIVE: To identify differences in patient characteristics, patterns of urate-lowering therapy (ULT) use, and gout control in gout patients with and without cardiovascular comorbidity...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28530163/gastrointestinal-histoplasmosis-a-case-series
#12
Rashi Sharma, Lipika Lipi, Smeeta Gajendra, Ishani Mohapatra, Ruchika K Goel, Rajan Duggal, Smruti Ranjan Mishra, Dheeraj Gautam
Histoplasmosis is an invasive mycosis caused by inhalation of the spores of dimorphic fungi Histoplasma capsulatum. The disease manifests in the lung as acute or chronic pulmonary histoplasmosis and in severe cases gets disseminated in multiple organs like skin, adrenal gland, central nervous system, lymph node, liver, spleen, bone marrow, and gastrointestinal tract. It occurs most commonly in immunodeficient patients like HIV-positive patients and transplant recipients, while immunocompetent hosts are affected rarely...
May 1, 2017: International Journal of Surgical Pathology
https://www.readbyqxmd.com/read/28529915/hemolytic-uremic-syndrome-in-adults-a-case-report
#13
Fabiel Gerardo Pérez-Cruz, Patricia Villa-Díaz, María Consuelo Pintado-Delgado, María Loreto Fernández Rodríguez, Ana Blasco-Martínez, María Pérez-Fernández
Thrombotic microangiopathies (TMA) are microvascular occlusive disorders characterized by platelet aggregation and mechanical damage to erythrocytes, clinically characterized by microangiopatic haemolytic anemia, thrombocytopenia and organ injury. We are reporting a case of a woman patient with severe hemolytic uremic syndrome associated to infectious diarrhoea caused by Shiga toxin-producing pathogen, who were admitted to our intensive care unit. The patient described developed as organ injury, neurological failure and acute renal failure, with need of haemodialysis technique...
May 4, 2017: World Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/28528190/association-between-the-time-to-surgery-and-survival-among-patients-with-colon-cancer-a-population-based-study
#14
J A Flemming, S Nanji, X Wei, C Webber, P Groome, C M Booth
Factors associated with time-to-surgery (TTS) and survival in colon cancer has not been well studied. Cancer Care Ontario recommends surgery within 42 days of diagnosis and that 90% of patients meet this benchmark. We describe factors associated with TTS and survival in routine clinical practice. METHODS: Retrospective population-based cohort study of patients receiving elective colonic resection after diagnosis of colon cancer in Ontario, Canada from 2002 to 2008 followed until 2012...
May 6, 2017: European Journal of Surgical Oncology
https://www.readbyqxmd.com/read/28528017/-identification-of-sentinel-events-in-primary-care
#15
G Olivera Cañadas, A Cañada Dorado, M Drake Canela, B Fernández-Martínez, G Ordóñez León, M Cimas Ballesteros
OBJECTIVE: To identify and describe a list of sentinel events (SEs) for Primary Care (PC). METHODODOLOGY: A structured experts' consensus was obtained by using two online questionnaires. The participants were selected because of their expertise in PC and patient safety. The first questionnaire assessed the suitability of the hospital SEs established in the National Quality Forum 2006 for use in PC via responses of "yes", "no", or "yes but with modification". In the latter case, a re-wording of the SE was requested...
May 17, 2017: Revista de Calidad Asistencial: Organo de la Sociedad Española de Calidad Asistencial
https://www.readbyqxmd.com/read/28527727/patient-outcomes-following-lower-leg-major-amputations-for-peripheral-arterial-disease-a-series-review
#16
Susan Monaro, Sandra West, Janice Gullick
INTRODUCTION: Despite improvements in revascularization, major amputation remains a significant part of the case-mix in vascular surgical units. These patients tend to be elderly with complex pathology, resulting in poor outcomes and longer lengths of stay (LOS). AIM: This series review provides a description of the patient complexities and outcomes in an Australian cohort undergoing major lower limb amputation for peripheral arterial disease. METHOD: Medical records coded for major amputation between July 2012 and June 2013 in an Australian government funded, tertiary hospital were retrospectively reviewed and descriptively analyzed...
June 2017: Journal of Vascular Nursing: Official Publication of the Society for Peripheral Vascular Nursing
https://www.readbyqxmd.com/read/28527721/indicators-and-outcomes-of-transfer-to-tertiary-pediatric-hospitals-for-patients-with-testicular-torsion
#17
Janae Preece, Christina Ching, Katelyn Yackey, Venkata Jayanthi, Daryl McLeod, Seth Alpert, Daniel DaJusta
INTRODUCTION: Testicular torsion threatens testicular viability with increased risk of loss with delayed management. Still, healthy adolescents continue to be transferred from community hospitals to tertiary hospitals for surgical management for torsion even though adult urologists may be available. We sought to determine reasons behind patient transfer and to evaluate whether transfer to tertiary centers for testicular torsion leads to increased rates of testicular loss. MATERIALS AND METHODS: A retrospective chart review was performed for patients presenting to our free-standing pediatric tertiary care facility with surgically confirmed testicular torsion during the 5-year period between January 2011 and January 2016...
April 27, 2017: Journal of Pediatric Urology
https://www.readbyqxmd.com/read/28526666/a-smart-toy-to-enhance-the-decision-making-process-at-children-s-psychomotor-delay-screenings-a-pilot-study
#18
María Angeles Gutiérrez García, María Luisa Martín Ruiz, Diego Rivera, Laura Vadillo, Miguel Angel Valero Duboy
BACKGROUND: EDUCERE ("Ubiquitous Detection Ecosystem to Care and Early Stimulation for Children with Developmental Disorders") is an ecosystem for ubiquitous detection, care, and early stimulation of children with developmental disorders. The objectives of this Spanish government-funded research and development project are to investigate, develop, and evaluate innovative solutions to detect changes in psychomotor development through the natural interaction of children with toys and everyday objects, and perform stimulation and early attention activities in real environments such as home and school...
May 19, 2017: Journal of Medical Internet Research
https://www.readbyqxmd.com/read/28526396/the-impact-of-initial-misdiagnosis-of-ruptured-abdominal-aortic-aneurysms-on-lead-times-complication-rate-and-survival
#19
K Smidfelt, C Drott, K Törngren, J Nordanstig, J Herlitz, M Langenskiöld
OBJECTIVE/BACKGROUND: To investigate the frequency of initial misdiagnosis and the clinical consequences of an initial misdiagnosis of ruptured abdominal aortic aneurysms (rAAA). METHODS: This was a retrospective cohort study. Data from the Swedish National Registry for Vascular Surgery (Swedvasc) and medical charts were extracted for patients treated for rAAA in the West of Sweden in the period 2008-14. Initially misdiagnosed patients were compared with correctly diagnosed patients...
May 16, 2017: European Journal of Vascular and Endovascular Surgery
https://www.readbyqxmd.com/read/28526241/-guidelines-for-prevention-detection-and-management-of-hyperbilirubinaemia-in-newborns-of-35-or-more-weeks-of-gestation
#20
María Dolores Sánchez-Redondo Sánchez-Gabriel, José Luis Leante Castellanos, Isabel Benavente Fernández, Alejandro Pérez Muñuzuri, Segundo Rite Gracia, Cesar W Ruiz Campillo, Ester Sanz López, Manuel Sánchez Luna
Hyperbilirubinaemia is one of the most frequent causes of hospital readmission during the first week of life. Its detection is still a big challenge, mainly due to the early discharge from the hospital that can be associated with a delay of the diagnosis. The identification of those newborns at risk of developing significant hyperbilirubinaemia is one of the main priorities in the public health care system. An approach to the management of newborn jaundice is presented in this article, following the recommendations based on the medical evidence and on the opinion of the Standards Committee of the Spanish Society of Neonatology...
May 16, 2017: Anales de Pediatría: Publicación Oficial de la Asociación Española de Pediatría (A.E.P.)
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