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medical admissions

Poul Jennum, Anne Sabers, Jakob Christensen, Rikke Ibsen, Jakob Kjellberg
PURPOSE: Epilepsy surgery has been a standard treatment for refractory epilepsies that cannot be controlled by standard medical treatment. We aimed to evaluate the health and social consequences of resective surgery relative to controls from a study of national data. METHODS: Using the Danish National Patient Registry we identified all subjects with an epilepsy diagnosis between 1996 and 2009 and compared them with a group of patients with an epilepsy diagnosis who had had neither epilepsy surgery nor a vagus stimulation diagnosis by the index date, and who were matched by gender, index year for epilepsy diagnosis, and index year for epilepsy surgery...
October 6, 2016: Seizure: the Journal of the British Epilepsy Association
Rocío Carmona, Cristina Linares, Cristina Ortiz, Blanca Vázquez, Julio Díaz
BACKGROUND: Although the effects of noise on population morbidity and mortality have been observed both in the short and long term, the morbidity and mortality indicators used to date have not enabled information on such health effects to be accessed in real time. At an international level, there are relatively few studies, mostly recent, which have considered an alternative indicator, such as the demand for medical attention provided by emergency services, taking into account environmental factors other than noise...
October 19, 2016: Environmental Research
Clarice L S Lopes, Paula Pitta Pinheiro, Luzia S Barberena, Guilherme U Eckert
OBJECTIVE: To describe the characteristics of children aged 0-14 years diagnosed with diabetic ketoacidosis and compare the following outcomes between children with prior diagnosis of type 1 diabetes mellitus (DM1) and children without prior diagnosis of DM1: length of hospital stay, severity on admission, insulin dosage, time of continuous insulin use, volume of fluids infused during treatment, and complications. METHODS: A retrospective descriptive study with review of medical records of patients admitted to the pediatric intensive care unit of a referral hospital from June 2013 to July 2015...
October 19, 2016: Jornal de Pediatria
Efe Levent Aras, Cody Bunger, Ebbe Stender Hansen, Rikke Søgaard
BACKGROUND AND PURPOSE: There is a lack of evidence on the broad health-care costs of treating spine trauma patients without neurological deficits conservatively. The aim of the present study was to estimate the primary and secondary health-care sector costs associated with conservative treatment of spine fractures as well as their determinants. METHODS: Patients were identified between 1999 and 2008 in the hospital's administrative system based on relevant diagnostic codes...
October 21, 2016: European Spine Journal
M S Tan, E J Teoh, C P Hor, A A C Yeoh
INTRODUCTION: Children who develop any hypersensitivity reaction to eggs are routinely referred to hospital for Measles-Mumps-Rubella (MMR) vaccination as inpatients to prevent anaphylaxis. We aimed to study the association between hypersensitivity reactions after egg exposure and similar reactions after MMR immunisation; and examine the necessity of hospital admission for vaccination. METHODS: A prospective observational study was conducted in Paediatric Department in Bukit Mertajam Hospital, Penang, between March and December 2014...
August 2016: Medical Journal of Malaysia
Magnolia Cardona-Morrell, Amanda Chapman, Robin M Turner, Ebony Lewis, Blanca Gallego-Luxan, Michael Parr, Ken Hillman
AIM: To investigate associations between clinical parameters - beyond the evident physiological deterioration and limitations of medical treatment - with in-hospital death for patients receiving Rapid Response System (RRS) attendances. METHODS: Retrospective case-control analysis of clinical parameters for 328 patients aged 60 years and above at their last RRS call during admission to a single teaching hospital in the 2012-2013 calendar years. Generalised estimating equation modelling was used to compare the deceased with a randomly selected sample of those who had RRS calls and survived admission (controls), matched by age group, sex, and hospital ward...
October 18, 2016: Resuscitation
Pierre Cornillon, Sébastien Loiseau, Bruno Aublet-Cuvelier, Virginie Guastella
BACKGROUND: Patients under palliative care and in hospital-at-home services are frequently transferred to emergency departments. We set out to identify the reasons for these presentations to determine the proportion that might be avoidable. METHODS: We conducted a retrospective study by assessment of patient files. We studied admissions to four emergency departments in an area of France (Puy-de-Dôme) between September 2011 and August 2013. Reasons for transfer and diagnostic conclusion by emergency doctors were noted...
October 21, 2016: BMC Palliative Care
Paibul Suriyawongpaisal, Wichai Aekplakorn, Samrit Srithamrongsawat, Chaisit Srithongchai, Orawan Prasitsiriphon, Rassamee Tansirisithikul
BACKGROUND: Although bodies of evidence on copayment effects on access to care and quality of care in general have not been conclusive, allowing copayment in the case of emergency medical conditions might pose a high risk of delayed treatment leading to avoidable disability or death. METHODS: Using mixed-methods approach to draw evidence from multiple sources (over 40,000 records of administrative dataset of Thai emergency medical services, in-depth interviews, telephone survey of users and documentary review), we are were able to shed light on the existence of copayment and its related factors in the Thai healthcare system despite the presence of universal health coverage since 2001...
October 21, 2016: BMC Health Services Research
Michèle M Kislan, Adam T Bernstein, Loretta R Fearrington, Timothy J Ives
BACKGROUND: Clinical Pharmacist Practitioners are advanced practicing pharmacists in North Carolina that provide disease-specific management. The purpose of this retrospective cohort study was to compare the efficacy and charges from referrals to a Clinical Pharmacist Practitioner by the primary care provider, to those managed by a primary care provider alone. METHODS: Patients were separated into cohorts depending if they had at least two appointments with a Clinical Pharmacist Practitioner from November 2008 to November 2011...
October 21, 2016: BMC Health Services Research
Pauline K Park, Jeremy W Cannon, Wen Ye, Lorne H Blackbourne, John B Holcomb, William Beninati, Lena M Napolitano
BACKGROUND: The overall incidence and mortality of acute respiratory distress syndrome (ARDS) in civilian trauma settings have decreased over the past four decades; however, the epidemiology and impact of ARDS on modern combat casualty care are unknown. We sought to determine the incidence, risk factors, resource utilization, and mortality associated with ARDS in current combat casualty care. METHODS: This was a retrospective review of mechanically ventilated US combat casualties within the Department of Defense Trauma Registry (formerly the Joint Theater Trauma Registry) during Operation Iraqi Freedom/Enduring Freedom (October 2001 to August 2008) for ARDS development, resource utilization, and mortality...
November 2016: Journal of Trauma and Acute Care Surgery
Rosa Maria Soares Madeira Domingues, Marcos Augusto Bastos Dias, Arthur Orlando Corrêa Schilithz, Maria do Carmo Leal
BACKGROUND: Maternal near-miss (MNM) audits are considered a useful approach to improving maternal healthcare. The aim of this study was to evaluate the factors associated with maternal near-miss cases in childbirth and the postpartum period in Brazil. METHODS: The study is based on data from a nationwide hospital-based survey of 23,894 women conducted in 2011-2012. The data are from interviews with mothers during the postpartum period and from hospital medical files...
October 17, 2016: Reproductive Health
Arun Agarwal, Aakanksha Agarwal
BACKGROUND: Hemophagocytic lymphohistiocytosis (HLH) is a rare, underdiagnosed, fatal and devastating hyperinflammatory syndrome that has gained increasing recognition over the past decade. Patients with HLH present with clinical and laboratory evidence of uncontrolled inflammation. Delay in diagnosis and management inevitably leads to a rapidly progressive and fatal course. In this case series, we present 7 cases of secondary HLH (sHLH) in adults with their presentation, course, and outcomes...
October 2016: Journal of the Association of Physicians of India
Ganesh Veerasekar, Krishnan Swaminathan
BACKGROUND: Using technology to track endemic areas of communicable diseases is possible nowadays. Effectual use of such facilities, especially in developing countries, will increase earlier detection of cases as well as aid in the formulation of effective prevention strategies. METHODS: A retrospective data analysis was carried out by collecting the details of patients presented with positive dengue serology, during the outbreak season in the second half of 2012, at Kovai Medical Center and Hospital, Coimbatore, India...
October 2016: Journal of the Association of Physicians of India
Alexandre Boulos, Katherine Rand, Josh A Johnson, Jacqueline Gautier, Michael Koster
Infections (including sepsis, meningitis, pneumonia and tetanus) stand as a major contributor to neonatal mortality in Haiti (22%). Infants acquire bacteria that cause neonatal sepsis directly from the mother's blood, skin or vaginal tract either before or during delivery. Nosocomial and environmental pathogens introduce further risk after delivery. The absence of cohesive medical systems and methods for collecting information limits the available data in countries such as Haiti. This study seeks to add more information on the burden of severe bacterial infections and their etiology in neonates of Haiti...
October 19, 2016: Journal of Tropical Pediatrics
Frank A Scannapieco, Summar Amin, Marc Salme, Mine Tezal
PURPOSE: To describe factors associated with the utilization of dental services in a long-term care facility (LTCF) in Western New York. METHODS AND MATERIALS: A descriptive cross-sectional study reviewed the dental and medical records of residents of an LTCF discharged between January 1, 2008 and December 30, 2012. Information on demographic and health variables at admission was extracted from electronic health records. Information on oral health variables was extracted from patient charts...
October 20, 2016: Special Care in Dentistry
M J Lin, F Baky, B C Housley, N Kelly, E Pletcher, J D Balshi, S P Stawicki, D C Evans
INTRODUCTION: Clinical information continues to be limited regarding changes in the temporal risk profile for readmissions during the initial postoperative year in vascular surgery patients. We set out to describe the associations between demographics, clinical outcomes, comorbidity indices, and hospital readmissions in a sample of patients undergoing common extremity revascularization or dialysis access (ERDA) procedures. We hypothesized that factors independently associated with readmission will evolve from "short-term" to "long-term" determinants at 30-, 180-, and 360-day postoperative cutoff points...
October 2016: Journal of Postgraduate Medicine
Joshua J Fenton, Kevin Fiscella, Anthony F Jerant, Francis Sousa, Mark Henderson, Tonya Fancher, Peter Franks
A diverse physician workforce is needed to increase access to care for underserved populations, particularly as the Affordable Care Act expands insurance coverage. Yet legal restrictions constrain the extent to which medical schools may use race/ethnicity in admissions decisions. We conducted simulations using academic metrics and socioeconomic data from applicants to a California public medical school from 2011 to 2013. The simulations systematically adjusted medical school applicants' academic metrics for socioeconomic disadvantage...
2016: Journal of Health Care for the Poor and Underserved
Paul L Schneider, Zhaoping Li
OBJECTIVE: To provide a thorough analysis of the range of ethical concerns that may present in relation to the care of the morbidly obese inpatient over the course of several years of care. METHODS: A narrative of the patient's complex medical care is given, with particular attention to the recommendations of three separate ethics committee consultations that were sought by his health care providers. An ethical analysis of the relevant issues is given within the Principles of Biomedical Ethics framework, highlighting the principles of autonomy, beneficence, non-maleficence, and justice...
2016: Narrative Inquiry in Bioethics
A E Cullen, L Bowers, M Khondoker, S Pettit, E Achilla, L Koeser, L Moylan, J Baker, A Quirk, F Sethi, D Stewart, P McCrone, A D Tulloch
AIMS: Within acute psychiatric inpatient services, patients exhibiting severely disturbed behaviour can be transferred to a psychiatric intensive care unit (PICU) and/or secluded in order to manage the risks posed to the patient and others. However, whether specific patient groups are more likely to be subjected to these coercive measures is unclear. Using robust methodological and statistical techniques, we aimed to determine the demographic, clinical and behavioural predictors of both PICU and seclusion...
October 20, 2016: Epidemiology and Psychiatric Sciences
Moon Seong Baek, Jeongsuk Son, Jin Won Huh, Chae-Man Lim, Younsuck Koh, Hye-Sung Won, Jae-Yoon Shim, Sang-Bum Hong
AIM: Some recent studies have reported that early intervention by a medical emergency team (MET) for clinical deterioration before intensive care unit (ICU) admission was associated with a survival benefit in critically ill cancer patients. We hypothesized that early MET intervention for an obstetric crisis in the general wards would be related to favorable outcomes in critically ill obstetric patients. METHODS: Data of obstetric patients who were managed by a MET were collected retrospectively from 1 March 2008 to 30 April 2015...
October 20, 2016: Journal of Obstetrics and Gynaecology Research
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