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https://www.readbyqxmd.com/read/28735459/diabetes-and-the-hospitalized-patient-a-cluster-analytic-framework-for-characterizing-the-role-of-sex-race-and-comorbidity-from-2006-to-2011
#1
Nisha Nataraj, Julie Simmons Ivy, Fay Cobb Payton, Joseph Norman
In the US, one in four adults has two or more chronic conditions; this population accounts for two thirds of healthcare spending. Comorbidity, the presence of multiple simultaneous health conditions in an individual, is increasing in prevalence and has been shown to impact patient outcomes negatively. Comorbidities associated with diabetes are correlated with increased incidence of preventable hospitalizations, longer lengths of stay (LOS), and higher costs. This study focuses on sex and race disparities in outcomes for hospitalized adult patients with and without diabetes...
July 22, 2017: Health Care Management Science
https://www.readbyqxmd.com/read/28734539/evidence-based-thresholds-for-the-volume-value-relationship-in-shoulder-arthroplasty-outcomes-and-economies-of-scale
#2
Prem N Ramkumar, Sergio M Navarro, Heather S Haeberle, Eric T Ricchetti, Joseph P Iannotti
BACKGROUND: Whereas several studies suggest that high-volume surgeons and hospitals deliver superior patient outcomes with greater cost efficiency, no evidence-based thresholds separating high-volume surgeons and hospitals from those that are low or medium volume exist in shoulder arthroplasty. The objective of this study was to establish meaningful thresholds that take outcomes and cost into consideration for surgeons and hospitals performing shoulder arthroplasty. METHODS: Using 9546 patients undergoing primary shoulder arthroplasty for osteoarthritis from an administrative database, we created and applied 4 models using stratum-specific likelihood ratio (SSLR) analysis of a receiver operating characteristic (ROC) curve...
August 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/28734198/length-of-stay-for-25-791-california-patients-found-incompetent-to-stand-trial
#3
Matthew Renner, Carol Newark, Bradley J Bartos, Richard McCleary, Nicholas Scurich
Referrals and admissions to state psychiatric hospitals of criminal defendants found Incompetent to Stand Trial (IST) are on the rise in the state of California and other parts of the country. Studies of treatment outcomes of this population have primarily focused on factors that determine competency and/or restorability. However, as IST patients place an increasing resource burden on state psychiatric hospital systems, other outcomes such as length of stay (LOS) are becoming increasingly important for practitioners and policy makers to understand...
July 6, 2017: Journal of Forensic and Legal Medicine
https://www.readbyqxmd.com/read/28733982/postoperative-complications-in-individuals-aged-70-and-over-undergoing-elective-surgery-for-colorectal-cancer
#4
Katleen Fagard, Julie Casaer, Albert Wolthuis, Johan Flamaing, Koen Milisen, Jean-Pierre Lobelle, Hans Wildiers, Cindy Kenis
AIM: This study aims to describe the nature, incidence, severity and outcomes of in-hospital postoperative complications (POCs) in older patients undergoing elective surgery for colorectal cancer (CRC).. METHOD: Patients were identified from a prospectively collected database (2009-2015) focusing on the implementation of geriatric screening and assessment in patients with cancer. Medical and surgical POCs were retrieved retrospectively from the medical records, and the severity of the POCs was graded by the Clavien-Dindo (CD) grading system...
July 22, 2017: Colorectal Disease: the Official Journal of the Association of Coloproctology of Great Britain and Ireland
https://www.readbyqxmd.com/read/28731912/assessing-infant-and-maternal-readiness-for-newborn-discharge
#5
Ling Jing, Casidhe-Nicole Bethancourt, Thomas McDonagh
PURPOSE OF REVIEW: The review highlights the shift from prescribed length of stay (LOS) to mother-infant dyad readiness as the basis for making discharge decisions for healthy term newborns. We describe the components of readiness that should be considered in making the decision, focusing on infant clinical readiness, and maternal and familial readiness. RECENT FINDINGS: Although the Newborns' and Mothers' Health Protection Act of 1996 aimed to protect infants and mothers by establishing a minimum LOS, the American Academy of Pediatrics 2015 policy on newborn discharge acknowledges the shift from LOS-based to readiness-based discharge decision-making...
July 20, 2017: Current Opinion in Pediatrics
https://www.readbyqxmd.com/read/28731843/telemedicine-use-decreases-rural-emergency-department-length-of-stay-for-transferred-north-dakota-trauma-patients
#6
Nicholas M Mohr, J Priyanka Vakkalanka, Karisa K Harland, Amanda Bell, Brian Skow, Dan M Shane, Marcia M Ward
BACKGROUND: Telemedicine has been proposed as one strategy to improve local trauma care and decrease disparities between rural and urban trauma outcomes. OBJECTIVES: This study was conducted to describe the effect of telemedicine on management and clinical outcomes for trauma patients in North Dakota. METHODS: Cohort study of adult (age ≥18 years) trauma patients treated in North Dakota Critical Access Hospital (CAH) Emergency Departments (EDs) from 2008 to 2014...
July 21, 2017: Telemedicine Journal and E-health: the Official Journal of the American Telemedicine Association
https://www.readbyqxmd.com/read/28731661/-melkersson-rosenthal-syndrome-report-of-two-pediatric-cases
#7
Lucas Bordino, Mariana L Juchli, Marcelo Fernández, María de Los Ángeles Fitz Maurice, Andrea Martins, Zaida E Ramírez, Roxana Spini
Melkersson Rosenthal syndrome is a very infrequent disease of unknown etiology, chronic and progressive course, with neurocutaneous disease that affects the orofacial innervation and mucocutaneous tissues with non-caseating granulomatous infiltration. Clinically, it is characterized by the diagnostic triad: recurrent edema of lips and/or face; recurrent and alternating acute peripheral facial paralysis and scrotal or geographic tongue. The condition generally presents as oligosymptomatic or monosymptomatic form...
August 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28731497/the-effect-of-frailty-on-short-term-outcomes-after-head-and-neck-cancer-surgery
#8
Carrie L Nieman, Karen T Pitman, Anthony P Tufaro, David W Eisele, Kevin D Frick, Christine G Gourin
OBJECTIVE: To determine the relationship between frailty and comorbidity, in-hospital mortality, postoperative complications, length of hospital stay (LOS), and costs in head and neck cancer (HNCA) surgery. STUDY DESIGN: Cross-sectional analysis. METHODS: Discharge data from the Nationwide Inpatient Sample for 159,301 patients who underwent ablative surgery for a malignant oral cavity, laryngeal, hypopharyngeal, or oropharyngeal neoplasm in 2001 to 2010 was analyzed using cross-tabulations and multivariate regression modeling...
July 21, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28730089/an-international-survey-of-classification-and-treatment-choices-for-group-d-retinoblastoma
#9
Christina Scelfo, Jasmine H Francis, Vikas Khetan, Thomas Jenkins, Brian Marr, David H Abramson, Carol L Shields, Jacob Pe'er, Francis Munier, Jesse Berry, J William Harbour, Andrey Yarovoy, Evandro Lucena, Timothy G Murray, Pooja Bhagia, Evelyn Paysse, Samuray Tuncer, Guillermo L Chantada, Annette C Moll, Tatiana Ushakova, David A Plager, Islamov Ziyovuddin, Carlos A Leal, Miguel A Materin, Xun-Da Ji, Jose W Cursino, Rodrigo Polania, Hayyam Kiratli, Charlotta All-Ericsson, Rejin Kebudi, Santosh G Honavar, Vicktoria Vishnevskia-Dai, Sidnel Epelman, Anthony B Daniels, Jeanie D Ling, Fousseyni Traore, Marco A Ramirez-Ortiz
AIM: To determine which IIRC scheme was used by retinoblastoma centers worldwide and the percentage of D eyes treated primarily with enucleation versus globe salvaging therapies as well as to correlate trends in treatment choice to IIRC version used and geographic region. METHODS: An anonymized electronic survey was offered to 115 physicians at 39 retinoblastoma centers worldwide asking about IIRC classification schemes and treatment patterns used between 2008 and 2012...
2017: International Journal of Ophthalmology
https://www.readbyqxmd.com/read/28729306/hospital-variation-in-allogeneic-transfusion-and-extended-length-of-stay-in-primary-elective-hip-and-knee-arthroplasty-a-cross-sectional-study
#10
Veronique M A Voorn, Perla J Marang-van de Mheen, Anja van der Hout, Cynthia So-Osman, M Elske van den Akker-van Marle, Ankie W M M Koopman-van Gemert, Albert Dahan, Thea P M Vliet Vlieland, Rob G H H Nelissen, Leti van Bodegom-Vos
OBJECTIVES: Outcomes in total hip and knee arthroplasty (THA and TKA), such as allogeneic transfusions or extended length of stay (LoS), can be used to compare the performance of hospitals. However, there is much variation in these outcomes. This study aims to rank hospitals and to assess hospital differences of two outcomes in THA and TKA: allogeneic transfusions and extended LoS, and to additionally identify factors associated with these differences. DESIGN: Cross-sectional medical record review study...
July 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28728827/the-use-of-perioperative-ketorolac-in-the-surgical-treatment-of-pediatric-spontaneous-pneumothorax
#11
R Michael Dorman, George Ventro, Sarah B Cairo, Kaveh Vali, David H Rothstein
BACKGROUND: We sought to determine the effect of ketorolac on pediatric primary spontaneous pneumothorax recurrence after operation. METHODS: The Pediatric Health Information System database was queried for patients ages 10-16years discharged in the years 2004-2014 with pneumothorax or pleural bleb and a related operative procedure. Deaths and secondary pneumothorax were excluded. Variables included demographics, chronic disease, intensive care unit admission, mechanical ventilation, and lung resection or plication...
June 23, 2017: Journal of Pediatric Surgery
https://www.readbyqxmd.com/read/28728743/outcomes-of-st-elevation-myocardial-infarction-complicated-by-out-of-hospital-cardiac-arrest-from-the-los-angeles-county-regional-system
#12
David M Shavelle, Nichole Bosson, Joseph L Thomas, Amy H Kaji, Gene Sung, William J French, James T Niemann
The objective of this study was to evaluate the time to primary percutaneous coronary intervention (PCI) and the outcome for patients with ST elevation myocardial infarction (STEMI) complicated by out-of-hospital cardiac arrest (OHCA). In this regional system, all patients with STEMI and/or OHCA with return of spontaneous circulation were transported to STEMI Receiving Centers. The outcomes registry was queried for patients with STEMI with underwent primary PCI from April 2011 to December 2014. Patients with STEMI complicated by OHCA were compared with a reference group of STEMI without OHCA...
June 15, 2017: American Journal of Cardiology
https://www.readbyqxmd.com/read/28727723/analytical-sensitivity-and-specificity-of-a-loop-mediated-isothermal-amplification-lamp-kit-prototype-for-detection-of-trypanosoma-cruzi-dna-in-human-blood-samples
#13
Susana A Besuschio, Mónica Llano Murcia, Alejandro F Benatar, Severine Monnerat, Israel Cruz Mata, Albert Picado de Puig, María de Los Ángeles Curto, Yutaka Kubota, Diana P Wehrendt, Paula Pavia, Yasuyoshi Mori, Concepción Puerta, Joseph M Ndung'u, Alejandro G Schijman
This study aimed to assess analytical parameters of a prototype LAMP kit that was designed for detection of Trypanosoma cruzi DNA in human blood. The prototype is based on the amplification of the highly repetitive satellite sequence of T.cruzi in microtubes containing dried reagents on the inside of the caps. The reaction is carried out at 65°C during 40 minutes. Calcein allows direct detection of amplified products with the naked eye. Inclusivity and selectivity were tested in purified DNA from Trypanosoma cruzi stocks belonging to the six discrete typing units (DTUs), in DNA from other protozoan parasites and in human DNA...
July 20, 2017: PLoS Neglected Tropical Diseases
https://www.readbyqxmd.com/read/28727674/the-community-balance-and-mobility-scale-a-valid-assessment-tool-of-balance-in-cardiac-rehabilitation-patients
#14
Luke Martelli, Dave Saraswat, Gail Dechman, Nicholas B Giacomantonio, Scott A Grandy
PURPOSE: Many patients participating in cardiac rehabilitation (CR) programs have decreased balance. This is a concern, as it may affect their ability to optimally perform physical exercise in CR and thus decrease CR efficacy. Despite this concern, balance is typically not assessed as part of CR intake. This may be attributable to the fact that a suitable balance assessment tool has not been identified for higher-functioning CR patients. A potential solution to this issue is using the Community Balance and Mobility Scale (CBMS), which has been used to assess balance in higher-functioning clinical populations; however, its use in a CR population has never been investigated...
July 19, 2017: Journal of Cardiopulmonary Rehabilitation and Prevention
https://www.readbyqxmd.com/read/28727381/nephrometry-scores-and-perioperative-outcomes-following-robotic-partial-nephrectomy
#15
Renato B Corradi, Emily A Vertosick, Daniel P Nguyen, Antoni Vilaseca, Daniel D Sjoberg, Nicole Benfante, Lucas N Nogueira, Massimiliano Spaliviero, Karim A Touijer, Paul Russo, Jonathan A Coleman
OBJECTIVES: Based on imaging features, nephrometry scoring systems have been conceived to create a standardized and reproducible way to characterize renal tumor anatomy. However, less is known about which of these individual measures are important with regard to clinically relevant perioperative outcomes such as ischemia time (IT), estimated blood loss (EBL), length of hospital stay (LOS), and change in estimated glomerular filtration rate (eGFR) after robotic partial nephrectomy (PN)...
July 20, 2017: International Braz J Urol: Official Journal of the Brazilian Society of Urology
https://www.readbyqxmd.com/read/28727227/long-term-outcomes-of-simultaneous-heart-and-kidney-transplantation-in-pediatric-recipients
#16
Patricia L Weng, Juan Carlos Alejos, Nancy Halnon, Qiuheng Zhang, Elaine F Reed, Eileen Tsai Chambers
Pediatric sHKTx has become an effective therapy for patients with combined cardiac and renal failure. Often, these patients develop human leukocyte antigen antibodies from their previous allografts and are therefore more difficult to re-transplant. We describe the largest case series of a predominantly sensitized pediatric sHKTx with emphasis on medical management and patient outcomes. Demographics, clinical characteristics, antibody, and biopsy data were retrospectively collected from University of California, Los Angeles database and correlated with short- and long-term patient and allograft outcomes of all sHKTx performed between 2002 and 2015...
July 20, 2017: Pediatric Transplantation
https://www.readbyqxmd.com/read/28726145/robotic-gastric-bypass-may-lead-to-fewer-complications-compared-with-laparoscopy
#17
Dimitrios Stefanidis, Savannah B Bailey, Timothy Kuwada, Connie Simms, Keith Gersin
BACKGROUND: Robotic technology leads to improved visualization and precision over laparoscopy but also higher cost of care. The benefits of this technology to patient outcomes are controversial. Our objective was to assess whether the application of robotic surgery to Roux-en-Y gastric bypass (RYGB) would lead to improved patient outcomes. METHODS: A prospectively collected database at a bariatric center of excellence was reviewed for all RYGB procedures performed by one surgeon between 2007 and 2015...
July 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28726037/can-a-collaborative-subspecialty-antimicrobial-stewardship-intervention-have-lasting-effects
#18
Kaushal B Shah, Ramzy H Rimawi, Mark A Mazer, Paul P Cook
OBJECTIVE: We previously demonstrated the benefit of direct, daily collaboration between infectious disease (ID) and critical care practitioners (CCP) on guideline adherence and antibiotic use in the medical intensive care unit (MICU). In this post-intervention review, we sought to establish whether the effect on antibiotic use and guideline adherence was sustainable. DESIGN: A retrospective review of 87 patients, admitted to the 24-bed MICU, was done 3 (n = 45) and 6 months (n = 42) after the intervention...
July 19, 2017: Infection
https://www.readbyqxmd.com/read/28725344/complete-response-of-mediastinal-clear-cell-sarcoma-to-pembrolizumab-with-radiotherapy
#19
Samuel Marcrom, Jennifer F De Los Santos, Robert M Conry
BACKGROUND: Clear cell sarcoma (CCS) is a rare, aggressive soft tissue sarcoma thought to derive from neural crest and characterized by a 12;22 translocation. The resulting fusion protein directly activates expression of the melanocyte master transcription factor and drives the same down-stream pathways in CCS and melanoma leading to significant clinical parallels between these malignancies. Striking success of immune checkpoint blockade in melanoma has promoted interest in immunotherapy of CCS...
2017: Clinical Sarcoma Research
https://www.readbyqxmd.com/read/28724333/the-impact-of-acute-management-on-the-occurrence-of-medical-complications-during-the-specialized-spinal-cord-injury-acute-hospitalization-following-motor-complete-cervical-spinal-cord-injury
#20
Andréane Richard-Denis, Debbie Erhmann Feldman, Cynthia Thompson, Jean-Marc Mac-Thiong
CONTEXT/OBJECTIVE: Determine the impact of early admission and complete perioperative management in a specialized spinal cord injury (SCI) trauma center (SCI-center) on the occurrence of medical complications following tetraplegia. DESIGN: A retrospective comparative cohort study of prospectively collected data involving 116 individuals was conducted. Group 1 (N=87) was early managed in a SCI-center promptly after the trauma, whereas Group 2 (N=29) was surgically and preoperatively managed in a non-specialized (NS) center before being transferred to the SCI-center...
July 19, 2017: Journal of Spinal Cord Medicine
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