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https://www.readbyqxmd.com/read/28334979/the-effectiveness-of-optimised-clinical-medication-reviews-for-geriatric-patients-opti-med-a-cluster-randomised-controlled-trial
#1
Floor Willeboordse, François G Schellevis, Sek Hung Chau, Jacqueline G Hugtenburg, Petra J M Elders
Background.: Inappropriate drug use is a frequent problem in older patients and associated with adverse clinical outcomes and an important determinant of geriatric problems. Clinical medication reviews (CMR) may reduce inappropriate drug use. Objective.: The aim of this study is to investigate the effectiveness of CMR on quality of life (QoL) and geriatric problems in comparison with usual care in older patients with geriatric problems in the general practice. Methods...
February 23, 2017: Family Practice
https://www.readbyqxmd.com/read/28334926/can-memory-assessment-services-mas-in-england-be-categorized-a-national-survey
#2
T Chrysanthaki, B Fernandes, S Smith, N Black
Background: The effectiveness and efficiency of memory assessment services (MASs) is unknown. Our aim was to determine if a typology can be constructed, based on shared structural and process characteristics, as a basis for a non-randomized evaluation of their effectiveness and cost-effectiveness. Methods: Survey of random sample of 73 MASs in 2015; comparison of characteristics and investigation of inter-correlation. Results: It was not possible to group characteristics to form the basis of a typology of MASs...
March 2, 2017: Journal of Public Health
https://www.readbyqxmd.com/read/28332356/comparison-of-clinical-outcomes-between-the-right-and-left-radial-artery-approaches-from-the-korean-transradial-coronary-intervention-registry
#3
Ji Young Park, Seung Woon Rha, Byong Geol Choi, Dong Ju Oh, Cheol Ung Choi, Young Jin Youn, Junghan Yoon
PURPOSE: Transradial intervention (TRI) shows anatomical and technical differences between the right radial approach (RRA) and left radial approach (LRA). The aim of this study was to evaluate the efficacy and safety using LRA, compared with RRA. MATERIALS AND METHODS: A total of 1653 consecutive patients who underwent TRI from November 2004 to October 2010 were enrolled in the Korean multicenter TRI registry. The patients were divided into two groups: the RRA group (n=792 patients) and the LRA group (n=861 patients)...
May 2017: Yonsei Medical Journal
https://www.readbyqxmd.com/read/28330452/a-structure-process-and-outcome-evaluation-of-the-geriatric-emergency-department-intervention-model-of-care-a-study-protocol
#4
Elizabeth Marsden, Andrea Taylor, Marianne Wallis, Alison Craswell, Marc Broadbent, Adrian Barnett, Kim-Huong Nguyen, Julia Crilly, Colleen Johnston, Amanda Glenwright
BACKGROUND: Emergency departments are chaotic environments in which complex, frail older persons living in the community and residential aged care facilities are sometimes subjected to prolonged emergency department lengths of stay, excessive tests and iatrogenic complications. Given the ageing population, the importance of providing appropriate, quality health care in the emergency department for this cohort is paramount. One possible solution, a nurse-led, physician-championed, emergency department gerontological intervention team, which provides frontload assessment, early collateral communication and appropriate discharge planning, has been developed...
March 23, 2017: BMC Geriatrics
https://www.readbyqxmd.com/read/28329032/early-and-mid-term-outcomes-of-endovascular-and-open-surgical-repair-of-non-dissected-aortic-arch-aneurysm%C3%A2
#5
Daijiro Hori, Homare Okamura, Takahiro Yamamoto, Satoshi Nishi, Koichi Yuri, Naoyuki Kimura, Atsushi Yamaguchi, Hideo Adachi
OBJECTIVES: With the introduction of endovascular stent graft technology, a variety of surgical options are available for patients with aortic aneurysms. We sought to evaluate early-term and mid-term outcomes of patients undergoing endovascular and open surgical repair for non-dissected aortic arch aneurysm. METHODS: Overall, 200 patients underwent treatment for isolated non-dissected aortic arch aneurysm between January 2008 and February 2016: 133 patients had open surgery and 67, endovascular repair...
February 22, 2017: Interactive Cardiovascular and Thoracic Surgery
https://www.readbyqxmd.com/read/28326464/meningiomas-in-pregnancy-timing-of-surgery-and-clinical-outcomes-as-observed-in-104-cases-and-establishment-of-a-best-management-strategy
#6
REVIEW
Yosef Laviv, Ahmed Bayoumi, Anand Mahadevan, Brett Young, Myles Boone, Ekkehard M Kasper
BACKGROUND: There is a strong correlation between the level of circulating female sex hormones and the parturient growth of meningiomas. As a result, rapid changes in meningioma size occur during pregnancy, putting both the mother and fetus at risk. Large, symptomatic meningiomas require surgical resection, regardless of the status of pregnancy. However, the preferred timing of such complex intervention is a matter of debate. The rarity of this clinical scenario and the absence of prospective trials make it difficult to reach evidence-based conclusions...
March 22, 2017: Acta Neurochirurgica
https://www.readbyqxmd.com/read/28321477/total-knee-arthroplasty-after-varus-distal-femoral-osteotomy-vs-native-knee-similar-results-in-a-case-control-study
#7
Romain Gaillard, Timothy Lording, Sebastien Lustig, Elvire Servien, Philippe Neyret
PURPOSE: The aim of this study was to investigate the results of total knee arthroplasty (TKA) performed after varus distal femoral osteotomy (VrDFO), in comparison to a control group of TKAs performed as the primary intervention for arthrosis. Main hypothesis was that the medium term results for the two groups would be similar. METHODS: All TKAs performed after VrDFO were extracted from a single centre, prospective database of 4046 arthroplasties. A case-control study was performed with a control group comprising two TKAs performed as the primary intervention for each TKA after VrDFO, and matched for sex, age at intervention, body mass index, the type of arthrosis and the type of implant...
March 20, 2017: Knee Surgery, Sports Traumatology, Arthroscopy: Official Journal of the ESSKA
https://www.readbyqxmd.com/read/28321299/successful-emergency-department-interventions-that-reduce-time-to-antibiotics-in-febrile-pediatric-cancer-patients
#8
Sandra Spencer, MIchele Nypaver, Katherine Hebert, Christopher Benner, Rachel Stanley, Daniel Cohen, Alexander Rogers, Jason Goldstick, Prashant Mahajan
Children with cancer and fever are at high risk for sepsis related death. Rapid antibiotic delivery (< 60 minutes) has been shown to reduce mortality. We compared patient outcomes and describe interventions from three separate quality improvement (QI) projects conducted in three United States (US) tertiary care pediatric emergency departments (EDs) with the shared aim to reduce time to antibiotic (TTA) to < 60 minutes in febrile pediatric oncology patients (Temperature > 38.0 C). A secondary objective was to identify interventions amenable to translation to other centers...
2017: BMJ Quality Improvement Reports
https://www.readbyqxmd.com/read/28316866/alberta-stroke-program-early-ct-score-in-the-prognostication-after-endovascular-treatment-for-ischemic-stroke-a-meta-analysis
#9
Chang-Woo Ryu, Hee Shup Shin, Soonchan Park, Sang Hyun Suh, Jun Seok Koh, Hye-Yeon Choi
PURPOSE: The Alberta Stroke Program Early CT Score (ASPECTS) was devised to quantify the extent of early ischemic changes in the middle cerebral artery territory on brain CT. We performed a systematic review and meta-analysis of studies that presented clinical outcomes and baseline ASPECTS in ischemic stroke patients managed with endovascular methods to validate the use of ASPECTS for risk prognostication. MATERIALS AND METHODS: We searched the MEDLINE, EMBASE, and Cochran databases for observational or interventional studies that reported clinical outcomes and baseline ASPECTS in ischemic stroke patients treated with endovascular methods...
March 2017: Neurointervention
https://www.readbyqxmd.com/read/28315940/a-multi-faceted-strategy-to-reduce-ventilation-associated-mortality-in-brain-injured-patients-the-bi-vili-project-a-nationwide-quality-improvement-project
#10
Karim Asehnoune, Ségolène Mrozek, Pierre François Perrigault, Philippe Seguin, Claire Dahyot-Fizelier, Sigismond Lasocki, Anne Pujol, Mathieu Martin, Russel Chabanne, Laurent Muller, Jean Luc Hanouz, Emmanuelle Hammad, Bertrand Rozec, Thomas Kerforne, Carole Ichai, Raphael Cinotti, Thomas Geeraerts, Djillali Elaroussi, Paolo Pelosi, Samir Jaber, Marie Dalichampt, Fanny Feuillet, Véronique Sebille, Antoine Roquilly
PURPOSE: We assessed outcomes in brain-injured patients after implementation of a multi-faceted approach to reduce respiratory complications in intensive care units. METHODS: Prospective nationwide before-after trial. Consecutive adults with acute brain injury requiring mechanical ventilation for ≥24 h in 20 French intensive care units (ICUs) were included. The management of invasive ventilation in brain-injured patients admitted between 1 July 2013 and 31 October 2013 (4 months) was monitored and analysed...
March 18, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28314676/first-and-second-generation-dess-reduce-diabetes-adverse-effect-on-mortality-and-re-intervention-in-multivessel-coronary-disease-9-year-analysis
#11
Sanaa A Badour, Kamellia R Dimitrova, Yumiko Kanei, Robert F Tranbaugh, Mark M Hajjar, Ameer Kabour, Thomas A Schwann, Samir Alam, Kamal Badr, Robert H Habib
BACKGROUND/PURPOSE: Diabetes portends an increased risk of adverse early and late outcomes in patients undergoing PCI. In this study, we aimed to investigate if the adverse effect of diabetes mellitus (DM) on early and late PCI outcomes is reduced with drug-eluting (DES) compared to bare-metal (BMS) stents. METHODS/MATERIALS: We reviewed the Mount Sinai Beth Israel Hospital first PCI experience for multivessel coronary artery disease (CAD, 1998-2009). Patients were excluded if they had single-vessel CAD, emergency, no stent, prior bypass graft or myocardial infarction <24h...
February 6, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28306694/real-world-use-of-ticagrelor-and-prasugrel-in-patients-with-nstemi-undergoing-percutaneous-coronary-intervention
#12
Vincenzo Sucato, Egle Corrado, Carmelo Castellana, Michele Carella, Simona Raso, Giuseppe Coppola, Giuseppe Andolina, Giuseppina Novo, Salvatore Evola, Salvatore Novo
OBJECTIVE: This retrospective observational study sought to describe the safety and efficacy profile of prasugrel and ticagrelor in patients with non-ST-segment elevation myocardial infarction (NSTEMI), who were admitted to the coronary intensive care unit (CICU) and underwent primary percutaneous coronary intervention (PCI). BACKGROUND AND METHODS: Dual antiplatelet therapy is mandatory for all the patients with acute coronary syndrome, who underwent PCI. Our study includes 111 patients with NSTEMI, who underwent PCI, in a maximum time of 72 h after their ischemic event...
March 16, 2017: Journal of Cardiovascular Medicine
https://www.readbyqxmd.com/read/28304142/biomarkers-and-anastomotic-leakage-in-colorectal-surgery-c-reactive-protein-trajectory-is-the-gold-standard
#13
Stephen R Smith, Peter Pockney, Ryan Holmes, Fiona Doig, John Attia, Elizabeth Holliday, Rosemary Carroll, Brian Draganic
BACKGROUND: Anastomotic leakage is a feared complication following colorectal surgery. Early prediction results in improved clinical outcome, but accurate predictive factors remain elusive. Many biomarkers have been studied with respect to diagnosis of anastomotic leakage but the concept of trajectory testing, using biomarkers, has not been assessed with regards to early diagnosis of anastomotic leak. METHODS: C-reactive protein (CRP), procalcitonin (PCT), white cell count (WCC) and gamma-glutamyl transferase were assessed for predictive utility in diagnosing anastomotic leakage with emphasis on identifying an association with change in their levels or trajectory...
March 17, 2017: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/28304095/postoperative-complications-of-total-laryngectomy-in-diabetic-patients
#14
Andrey Filimonov, Jacob S Brady, Aparna Govindan, Aziz Merchant, Jean Anderson Eloy, Soly Baredes, Richard Chan Woo Park
OBJECTIVES/HYPOTHESIS: Analyze postoperative complications of total laryngectomies (TL) in patients with diabetes mellitus and apply these data toward preoperative management of diabetic patients undergoing TL. STUDY DESIGN: Retrospective analysis of surgical outcomes database METHODS: The American College of Surgeons National Surgical Quality Improvement Program database was queried for TL performed between 2005 and 2013. Comparison of demographics, preoperative comorbidities, and postoperative outcomes in a diabetic versus a nondiabetic cohort was conducted using SPSS software...
March 17, 2017: Laryngoscope
https://www.readbyqxmd.com/read/28303630/comparison-of-5-year-outcomes-of-paclitaxel-eluting-and-endeavor-zotarolimus-eluting-stents-in-new-york
#15
Feng Qian, Ye Zhong, Edward L Hannan
OBJECTIVES: To evaluate long-term outcomes in patients undergoing either paclitaxel-eluting stents (PES) or endeavor zotarolimus-eluting stents (E-ZES) placement and to assess comparative effectiveness of PES vs. E-ZES in different "off-label" and "high-risk" patient subgroups. BACKGROUND: PES and E-ZES are frequently used in percutaneous coronary interventions (PCIs). However, the long-term comparative effectiveness of PES vs. E-ZES in real practice is unknown...
March 17, 2017: Catheterization and Cardiovascular Interventions
https://www.readbyqxmd.com/read/28302178/laser-peripheral-iridotomy-versus-laser-peripheral-iridotomy-plus-laser-peripheral-iridoplasty-in-the-treatment-of-multi-mechanism-angle-closure-study-protocol-for-a-randomized-controlled-trial
#16
Shida Chen, Jianhua Lv, Sujie Fan, Hong Zhang, Lin Xie, Ling Xu, Bing Jiang, Huipin Yuan, Yuanbo Liang, Shuning Li, Pingyan Chen, Xiulan Zhang, Ningli Wang
BACKGROUND: China has the largest burden of primary angle-closure glaucoma (PACG) worldwide. The mechanism of the angle closure is complex and includes pupillary block and non-pupillary block. Currently, opinion is that laser peripheral iridotomy (LPI) alone is not sufficient to prevent disease progression. Laser peripheral iridoplasty (LPIP) is an alternative and effective way of widening the angle recess in eyes that are affected by primary angle closure (PAC). However, it is not known if greater benefit would be achieved using LPI plus LPIP for PAC with multiple mechanisms (MAC)...
March 17, 2017: Trials
https://www.readbyqxmd.com/read/28302130/comparison-of-distraction-arthroplasty-alone-versus-combined-with-arthroscopic-microfracture-in-treatment-of-post-traumatic-ankle-arthritis
#17
Kaibin Zhang, Yiqiu Jiang, Jing Du, Tianqi Tao, Wang Li, Yang Li, Jianchao Gui
BACKGROUND: This study aims to compare clinical outcomes of distraction arthroplasty alone versus combined with arthroscopic microfracture in treating post-traumatic ankle arthritis. METHODS: The study cohort consisted of 96 patients (96 ankles) who underwent distraction arthroplasty alone or combined with arthroscopic microfracture between May 2005 and April 2012. Patients were divided into the distraction group (n = 46) and the combined group (n = 50)...
March 17, 2017: Journal of Orthopaedic Surgery and Research
https://www.readbyqxmd.com/read/28301451/traumatic-brain-injury-related-emergency-department-visits-hospitalizations-and-deaths-united-states-2007-and-2013
#18
Christopher A Taylor, Jeneita M Bell, Matthew J Breiding, Likang Xu
PROBLEM/CONDITION: Traumatic brain injury (TBI) has short- and long-term adverse clinical outcomes, including death and disability. TBI can be caused by a number of principal mechanisms, including motor-vehicle crashes, falls, and assaults. This report describes the estimated incidence of TBI-related emergency department (ED) visits, hospitalizations, and deaths during 2013 and makes comparisons to similar estimates from 2007. REPORTING PERIOD: 2007 and 2013. DESCRIPTION OF SYSTEM: State-based administrative health care data were used to calculate estimates of TBI-related ED visits and hospitalizations by principal mechanism of injury, age group, sex, and injury intent...
March 17, 2017: MMWR. Surveillance Summaries: Morbidity and Mortality Weekly Report. Surveillance Summaries
https://www.readbyqxmd.com/read/28300757/analysis-of-outcomes-of-the-nrs-2002-in-patients-hospitalized-in-nephrology-wards
#19
Paulina Borek, Michał Chmielewski, Sylwia Małgorzewicz, Alicja Dębska Ślizień
INTRODUCTION: Malnutrition is a common problem among hospitalized patients. In chronic kidney disease, it affects up to 50% of the population. Undernourishment has an adverse effect on prognosis and prolongs convalescence. The aim of the study was to test the effectiveness of NRS (Nutrition Risk Screening) -2002 in the assessment of risk of malnutrition for patients hospitalized in nephrology wards. The aim was to develop clinical characteristics of malnourished patients and to assess the relationship between nutritional status and patient outcome...
March 16, 2017: Nutrients
https://www.readbyqxmd.com/read/28298050/intra-articular-steroid-injection-for-frozen-shoulder
#20
Yaying Sun, Peng Zhang, Shaohua Liu, Hong Li, Jia Jiang, Shiyi Chen, Jiwu Chen
BACKGROUND: Intra-articular steroid injection is a common intervention for frozen shoulder (FS). PURPOSE: This review aimed to illustrate the effects of intra-articular steroid injection for FS. STUDY DESIGN: Systematic review and meta-analysis. METHODS: PubMed, Embase, and the Cochrane Library were searched for randomized controlled trials (RCTs) comparing intra-articular steroid injection with no injection or sham injections for FS...
October 1, 2016: American Journal of Sports Medicine
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