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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
#1
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
#2
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
#3
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
#4
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
#5
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
#6
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
#7
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
#8
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
#9
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
#10
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
#11
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
https://www.readbyqxmd.com/read/28295894/cost-effectiveness-analysis-appraisal-and-application-an-emergency-medicine-perspective
#12
Michael D April, Brian P Murray
Cost-effectiveness is an important goal for emergency care delivery. The many diagnostic, treatment, and disposition decisions made in the emergency department (ED) have a significant impact upon healthcare resource utilization. Cost-effectiveness analysis (CEA) is an analytic tool to optimize these resource allocation decisions through the systematic comparison of costs and effects of alternative healthcare decisions. Yet few emergency medicine leaders and policy-makers have any formal training in CEA methodology...
March 10, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
https://www.readbyqxmd.com/read/28293500/a-systematic-review-of-metoidioplasty-and-radial-forearm-flap-phalloplasty-in-female-to-male-transgender-genital-reconstruction-is-the-ideal-neophallus-an-achievable-goal
#13
Jordan D Frey, Grace Poudrier, Michael V Chiodo, Alexes Hazen
INTRODUCTION: The complex anatomy and function of the native penis is difficult to surgically replicate. Metoidioplasty and radial forearm flap phalloplasty (RFFP) are the 2 most commonly utilized procedures for transgender neophallus construction. METHODS: A MEDLINE search for metoidioplasty and RFFP in female-to-male genital reconstruction was performed. Primary outcome measures were subsequently compared. A systematic review was planned in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyse guidelines...
December 2016: Plastic and Reconstructive Surgery. Global Open
https://www.readbyqxmd.com/read/28293329/evaluation-of-a-gait-assessment-module-using-3d-motion-capture-technology
#14
Amanda J Baskwill, Patricia Belli, Leila Kelleher
BACKGROUND: Gait analysis is the study of human locomotion. In massage therapy, this observation is part of an assessment process that informs treatment planning. Massage therapy students must apply the theory of gait assessment to simulated patients. At Humber College, the gait assessment module traditionally consists of a textbook reading and a three-hour, in-class session in which students perform gait assessment on each other. In 2015, Humber College acquired a three-dimensional motion capture system...
March 2017: International Journal of Therapeutic Massage & Bodywork
https://www.readbyqxmd.com/read/28291697/early-prehospital-assessment-of-non-urgent-patients-and-outcomes-at-the-appropriate-level-of-care-a-prospective-exploratory-study
#15
Glenn Larsson, Anders Holmén, Kristina Ziegert
INTRODUCTION: The Ambulance Organization of Sweden provides qualified medical assessment and treatment by ambulance nurses based on patient needs regarding appropriate levels of care. A new model for patients with non-urgent medical conditions has been introduced. The main objective of this study was to examine early prehospital assessment of non-urgent patients, and its impact on the choice of the appropriate level of care. METHODS: The study design was a 1-year, prospective study, involving an ambulance district in southwestern Sweden with a population of 78,000...
March 10, 2017: International Emergency Nursing
https://www.readbyqxmd.com/read/28291667/medical-therapy-versus-balloon-angioplasty-for-cteph-a-systematic-review-and-meta-analysis
#16
Kevin Phan, Helen E Jo, Joshua Xu, Edmund M Lau
BACKGROUND: A significant number of chronic thromboembolic pulmonary hypertension (CTEPH) patients will have an inoperable disease. Medical therapy and balloon pulmonary angioplasty (BPA) have provided alternate therapeutic options for patients with inoperable CTEPH, although there are a limited number of published studies examining the outcomes. Thus, our study aims to evaluate and compare the efficacy of medical therapy and BPA in patients with inoperable CTEPH. METHODS: An electronic search of six databases was performed and the search results were screened against established criteria for inclusion into this study...
March 1, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28289812/the-icm-research-agenda-on-intensive-care-unit-acquired-weakness
#17
Nicola Latronico, Margaret Herridge, Ramona O Hopkins, Derek Angus, Nicholas Hart, Greet Hermans, Theodore Iwashyna, Yaseen Arabi, Giuseppe Citerio, E Wesley Ely, Jesse Hall, Sangeeta Mehta, Kathleen Puntillo, Johannes Van den Hoeven, Hannah Wunsch, Deborah Cook, Claudia Dos Santos, Gordon Rubenfeld, Jean-Louis Vincent, Greet Van den Berghe, Elie Azoulay, Dale M Needham
We present areas of uncertainty concerning intensive care unit-acquired weakness (ICUAW) and identify areas for future research. Age, pre-ICU functional and cognitive state, concurrent illness, frailty, and health trajectories impact outcomes and should be assessed to stratify patients. In the ICU, early assessment of limb and diaphragm muscle strength and function using nonvolitional tests may be useful, but comparison with established methods of global and specific muscle strength and physical function and determination of their reliability and normal values would be important to advance these techniques...
March 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28288272/interventions-to-improve-inhaler-technique-for-people-with-asthma
#18
REVIEW
Rebecca Normansell, Kayleigh M Kew, Alexander G Mathioudakis
BACKGROUND: Asthma is a common chronic disease worldwide. Inhalers are often prescribed to help control asthma symptoms, improve quality of life and reduce the risk of exacerbations or flare-ups. However, evidence suggests that many people with asthma do not use their inhaler correctly. It is therefore important to evaluate whether interventions aimed specifically at improving technique are effective and safe, and whether use of these interventions translates into improved clinical outcomes...
March 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28288075/an-electronic-health-record-based-intervention-to-promote-hepatitis-c-virus-testing-among-adults-born-between-1945-and-1965-a-cluster-randomized-trial
#19
Alex D Federman, Natalie Kil, Joseph Kannry, Evie Andreopolous, Wilma Toribio, Joanne Lyons, Mark Singer, Anthony Yartel, Bryce D Smith, David B Rein, Katherine Krauskopf
BACKGROUND: The Centers for Disease Control and Prevention (CDC) recommends one-time hepatitis C virus (HCV) antibody testing for "Birth Cohort" adults born during 1945-1965. OBJECTIVE: To examine the impact of an electronic health record (EHR)-embedded best practice alert (BPA) for HCV testing among Birth Cohort adults. DESIGN: Cluster-randomized trial was conducted from April 29, 2013 to March 29, 2014. SUBJECTS AND SETTING: Ten community and hospital-based primary care practices...
March 10, 2017: Medical Care
https://www.readbyqxmd.com/read/28285957/comparison-of-renal-outcomes-in-patients-treated-by-zenith-%C3%A2-fenestrated-and-zenith-%C3%A2-abdominal-aortic-aneurysm-stent-grafts-in-us-prospective-pivotal-trials
#20
L R de Souza, G S Oderich, M A Farber, S Haulon, P V Banga, A H Pereira, P Gloviczki, S C Textor, F Jia
OBJECTIVE/BACKGROUND: Fenestrated endovascular repair (FEVAR) has been used to treat complex abdominal aortic aneurysms (AAAs). The risk of renal function deterioration compared with infrarenal endovascular aortic repair (EVAR) has not been determined. METHODS: Patients with preserved renal function (estimated glomerular filtration rate [eGFR] > 45 mL/minute) enrolled in two prospective, non-randomised studies evaluating Zenith fenestrated and AAA stent grafts were matched (1:2) by propensity scores for age, sex, hypertension, diabetes, and pre-operative eGFR...
March 10, 2017: European Journal of Vascular and Endovascular Surgery
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