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https://www.readbyqxmd.com/read/27911071/severe-brain-injury-in-massachusetts-assessing-the-continuum-of-care
#1
Laura Lorenz, Gabrielle Katz
Acquired brain injury (ABI) is a major public health problem in Massachusetts (Hackman et al, 2014) and includes traumatic brain injury (TBI), stroke, ABI-related infectious diseases, metabolic disorders affecting the central nervous system (brain and spinal cord), and brain tumor. Advances in emergency medical care and neurosurgery mean that more people are surviving severe traumatic brain injury (Trexler et al, 2014). Yet many patients with severe TBI in particular, are not receiving inpatient services after initial treatment (Hackman et al, 2014; CDC, 2014) or later that are known to be effective (Malec & Kean, 2015; Lewis & Horn, 2015; BI Commission, 2011; Kolakowsky-Hayner et al, 2000; Interviews)...
December 10, 2015: Issue Brief
https://www.readbyqxmd.com/read/27910796/reinforcement-of-emergency-department-reduces-acute-admissions-to-medical-department
#2
Mansoor Ahmed Dawood, Gideon Ertner, Jacob Hansen-Schwartz
INTRODUCTION: The medical decision capacity of emergency departments (ED) may rest within the department itself or depend on external consultation. The stepwise development of the ED at Zealand University Hospital, Køge, was used to analyse the influence of medical organisation in the ED on the hospital admission pattern. METHODS: Data were recorded for the month of September of 2009, 2012 and 2014. These periods corresponded to the establishment of the department in 2009 and the 2012-period before organisational change was initiated in 2013, with a substantial increase in the number of senior physicians directly in charge of clinical decisions and the establishment of a limited bedding capacity...
December 2016: Danish Medical Journal
https://www.readbyqxmd.com/read/27908822/how-admission-to-a-vascular-surgery-department-improves-medical-treatment-in-patients-with-lower-extremity-peripheral-arterial-disease
#3
M Thiney, N Della Schiava, P Feugier, P Lermusiaux, J Ninet, A Millon, A Long
OBJECTIVES: All patients with lower extremity peripheral arterial disease (LE-PAD) should benefit from recommended pharmacologic therapies including antiplatelet agents, angiotensin converting enzyme (ACE) inhibitors or Angiotensin receptor blockers (ARBs), and HMG-CoA-reductase inhibitors (statins). In the present study, this triple therapy was defined as the best medical treatment. This study was designed to determine the number of patients who received best medical treatment at admission and at discharge from a vascular surgery department...
November 28, 2016: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/27907046/pre-stage-acute-kidney-injury-can-predict-mortality-and-medical-costs-in-hospitalized-patients
#4
Jeonghwan Lee, Seon Ha Baek, Shin Young Ahn, Ho Jun Chin, Ki Young Na, Dong-Wan Chae, Sejoong Kim
The significance of minimal increases in serum creatinine below the levels indicative of the acute kidney injury (AKI) stage is not well established. We aimed to investigate the influence of pre-stage AKI (pre-AKI) on clinical outcomes. We enrolled a total of 21,261 patients who were admitted to the Seoul National University Bundang Hospital from January 1, 2013 to December 31, 2013. Pre-AKI was defined as a 25-50% increase in peak serum creatinine levels from baseline levels during the hospital stay. In total, 5...
2016: PloS One
https://www.readbyqxmd.com/read/27906164/early-sigmoidoscopy-or-colonoscopy-is-associated-with-improved-hospital-outcomes-in-ulcerative-colitis-related-hospitalization
#5
Kenneth Obi, Alice Hinton, Lindsay Sobotka, Razvan Arsenescu, Somashekar G Krishna, Edward J Levine, Cheng Zhang
OBJECTIVES: Performing a sigmoidoscopy or colonoscopy is recommended for assessment of disease activity, excluding infection, and guiding medical treatment during ulcerative colitis (UC)-related hospitalizations. However, it is unknown whether the timing of endoscopy impacts clinical outcomes. The objective of our study was to determine the impact of timing of endoscopy on hospital outcomes in patients with UC-related hospitalizations. METHODS: This is a cross-sectional study using data from the Nationwide Inpatient Sample database (2006-2013)...
December 1, 2016: Clinical and Translational Gastroenterology
https://www.readbyqxmd.com/read/27905922/influence-of-combined-therapy-with-conventional-and-herbal-medicines-on-liver-function-in-138-inpatients-with-abnormal-liver-transaminase-levels
#6
Jun Hyuk Shin, Kyuseok Kim, Hae Jeong Nam
BACKGROUND: To evaluate the influence of combined therapy of conventional and herbal medicines on liver function. METHODS: This study was a retrospective chart review. A total of 138 patients with abnormal liver transaminase levels at the time of admission were included in this study. We evaluated the influence of combined therapy of conventional and herbal medicines on liver transaminase levels over a period of at least 2 weeks at Kyung Hee University Korean Medical Hospital...
December 1, 2016: BMC Complementary and Alternative Medicine
https://www.readbyqxmd.com/read/27905180/frequency-and-cost-of-acute-surgical-admissions-in-over-anticoagulated-patients-over-anticoagulation-in-the-community
#7
Moea Nimmo, Delwyn Armstrong, Jonathan B Koea
BACKGROUND: Anticoagulation treatment in the community is common. This investigation was undertaken to determine the frequency of patient surgical admission with conditions associated with over-anticoagulation in the community and the surgical resource required to effectively and safely manage these patients acutely. METHODS: Hospital discharge data on individual patients admitted to Waitemata District Health Board hospitals between December 2014 and November 2015 inclusive were reviewed...
December 1, 2016: ANZ Journal of Surgery
https://www.readbyqxmd.com/read/27905143/characterization-of-adverse-drug-reactions-causing-admission-to-an-intensive-care-unit
#8
Camilo Rojas-Velandia, Jair Ruiz-Garzón, Juan-Carlos Moscoso-Alcina, Álvaro Vallejos-Narvaéz, Jenny Castro-Canoa, Yuri Bustos-Martínez, Max Flórez-Cutiva, Mabel Contreras-Muñoz, Jully-Carolina Gómez-Gil, Carlos-Alberto Calderón-Ospina
AIM: This study aimed to determine the occurrence of adverse drug reactions (ADRs) that caused admission to the intensive care unit (ICU) of a university hospital. METHODS: Clinical records were reviewed for patients meeting the inclusion criteria who were admitted to the ICU between September and December 2012. Suspected cases of adverse drug reactions (ADR) were documented. Nine researchers later evaluated causality using the Naranjo Algorithm, preventability using the Schumock and Thornton criteria, and clinical classification based on the dose-time-susceptibility (DoTS) system...
December 1, 2016: British Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/27904601/evaluation-effects-of-nebulized-gentamicin-in-exacerbation-of-chronic-obstructive-lung-disease
#9
Forogh Soltaninejad, Soleiman Kheiri, Roya Habibian, Arshia Amra, Shahin Asgari-Savadjani
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is a major cause of chronic morbidity and mortality throughout the world. Exacerbation of COPD has negative effect on quality of life. Therapeutic effect of nebulized antibiotics in pulmonary infections has been reported previously. Hence, we evaluated the effect of nebulized gentamicin in acute exacerbation of COPD (AECOPD). MATERIALS AND METHODS: In this clinical trial study, 86 hospitalized patients with AECOPD were divided into two groups for using nebulized gentamicin twice daily (case group) and placebo (control group) for 5 days in addition to standard treatment...
2016: Journal of Research in Medical Sciences: the Official Journal of Isfahan University of Medical Sciences
https://www.readbyqxmd.com/read/27904269/serum-procalcitonin-level-reflects-the-severity-of-cellulitis
#10
Soo Hyeon Noh, Seok Don Park, Eun Jung Kim
BACKGROUND: Cellulitis is a common bacterial infection of the superficial skin. Procalcitonin is one of the precursor proteins of calcitonin, its levels are elevated in bacterial infection, and it has been established as a diagnostic marker for severe bacterial infections. OBJECTIVE: This study evaluated the clinical usefulness of procalcitonin for predicting disease severity and prognosis of cellulitis. METHODS: We reviewed the medical records of 160 patients diagnosed with cellulitis in the past 3 years...
December 2016: Annals of Dermatology
https://www.readbyqxmd.com/read/27904169/lean-umbilical-cord-a-case-report
#11
N Rippinger, M Elsässer, P Sinn, C Sohn, H Fluhr
The "lean" umbilical cord (also known as thin-cord syndrome) is a comparatively rare anomaly of the umbilical cord, which has seldom been described in the medical literature. We report on a 35-year-old women who presented to us at 29 + 4 weeks gestation with vaginal bleeding and cervical incompetence subsequently complicated not only by premature rupture of membranes but also acute placental insufficiency requiring emergency caesarean section under general anaesthesia at 31 + 2 weeks gestation. At surgery no obvious cause for the acute placental insufficiency - such as placental abruption, cord prolapse or true knot of the umbilical cord - was found...
November 2016: Geburtshilfe und Frauenheilkunde
https://www.readbyqxmd.com/read/27903446/polycystic-ovary-syndrome-an-under-recognized-cause-of-abnormal-uterine-bleeding-in-adolescents-admitted-to-a-children-s-hospital
#12
Sofya Maslyanskaya, Hina J Talib, Jennifer L Northridge, Amanda M Jacobs, Chanelle Coble, Susan M Coupey
STUDY OBJECTIVE: To evaluate whether ovulatory dysfunction due to polycystic ovary syndrome (PCOS) is a common underlying etiology of abnormal uterine bleeding (AUB) in adolescents requiring hospitalization and to explore etiology, treatment and complications of AUB with severe anemia in adolescents. DESIGN: We identified females aged 8 to 20 years admitted to a children's hospital for treatment of AUB from January 2000 to December 2014. Our hospital protocol advises hormonal testing for PCOS and other disorders prior to treatment for AUB...
November 26, 2016: Journal of Pediatric and Adolescent Gynecology
https://www.readbyqxmd.com/read/27903117/risk-factors-associated-with-the-surgical-management-of-craniopharyngiomas-in-pediatric-patients-analysis-of-1961-patients-from-a-national-registry-database
#13
Joshua Bakhsheshian, Diana L Jin, Ki-Eun Chang, Ben A Strickland, Dan A Donoho, Steven Cen, William J Mack, Frank Attenello, Eisha A Christian, Gabriel Zada
OBJECTIVE Patient demographic characteristics, hospital volume, and admission status have been shown to impact surgical outcomes of sellar region tumors in adults; however, the data available following the resection of craniopharyngiomas in the pediatric population remain limited. The authors sought to identify potential risk factors associated with outcomes following surgical management of pediatric craniopharyngiomas. METHODS The Nationwide Inpatient Sample database and Kids' Inpatient Database were analyzed to include admissions for pediatric patients (≤ 18 years) who underwent a transcranial or transsphenoidal craniotomy for resection of a craniopharyngioma...
December 2016: Neurosurgical Focus
https://www.readbyqxmd.com/read/27903032/-interventional-left-atrial-appendage-closure-in-a-patient-with-gave-syndrome
#14
Christian Fastner, Sebastian Belle, Ibrahim Akin
History and findings | A 56-year-old female with a gastric antral vascular ectasia (GAVE) suffered from recurrent episodes of upper gastrointestinal bleeding. Because of a history of a permanent atrial fibrillation (CHA2DS2-VASc score 3 points) an oral anticoagulation therapy with phenprocoumon was carried out which even worsened the bleeding frequency and intensity. A change of medication to low-molecular weight heparin did not lead to success. The frequent periods in hospital limited the patient's quality of life...
November 2016: Deutsche Medizinische Wochenschrift
https://www.readbyqxmd.com/read/27902956/usefulness-of-cervical-computed-tomography-and-magnetic-resonance-imaging-for-rapid-diagnosis-of-crowned-dens-syndrome-a-case-report-and-review-of-the-literature
#15
Akihiro Inoue, Kanehisa Kohno, Satoko Ninomiya, Hitomi Tomita, Shinji Iwata, Shiro Ohue, Kenji Kamogawa, Kensho Okamoto, Shinya Fukumoto, Haruhisa Ichikawa, Shinji Onoue, Saya Ozaki, Bungo Okuda
INTRODUCTION: Crowned dens syndrome is a rare disease entity which radiologically shows calcification of the cruciform ligament around the odontoid process. We report a patient with crowned dens syndrome who improved dramatically in 5days following treatment with oral nonsteroidal anti-inflammatory medication. PRESENTATION OF CASE: A 61-year-old man was admitted to our hospital with a severe occipital headache and sudden onset of neck stiffness. Neurological examination on admission revealed a high fever and cervical rigidity...
November 23, 2016: International Journal of Surgery Case Reports
https://www.readbyqxmd.com/read/27902720/intervention-to-improve-appropriate-prescribing-and-reduce-polypharmacy-in-elderly-patients-admitted-to-an-internal-medicine-unit
#16
Milena Urfer, Luigia Elzi, Salome Dell-Kuster, Stefano Bassetti
BACKGROUND: Polypharmacy and inappropriate medication prescriptions are associated with increased morbidity and mortality. Most interventions proposed to improve appropriate prescribing are time and resource intensive and therefore hardly applicable in daily clinical practice. OBJECTIVE: To test the efficacy of an easy-to-use checklist aimed at supporting the therapeutic reasoning of physicians in order to reduce inappropriate prescribing and polypharmacy. METHODS: We assessed the efficacy and safety of a 5-point checklist to be used by all physicians on the internal medicine wards of a Swiss hospital by comparing outcomes in 450 consecutive patients aged ≥65 years hospitalized after the introduction of the checklist, and in 450 consecutive patients ≥65 years hospitalized before the introduction of the checklist...
2016: PloS One
https://www.readbyqxmd.com/read/27902671/prehospital-transport-for-pediatric-trauma-a-comparison-of-private-transport-and-emergency-medical-services
#17
Yea-Chyi Lin, York Tien Lee, Jasmine Xun Yi Feng, Li Wei Chiang, Shireen Anne Nah
OBJECTIVES: We describe the demographics of pediatric patients with trauma transferred using private transport (PT) versus emergency medical services (EMS) and evaluate the potential impact on their treatment and outcome. METHODS: We accessed data from our national trauma registry, a prospectively collected database. Data were extracted on all patients with trauma admitted to our institution between January 2011 and June 2013, with injury severity score (ISS) higher than 8...
November 29, 2016: Pediatric Emergency Care
https://www.readbyqxmd.com/read/27902575/veterans-voice-through-the-lens-of-their-medical-records-what-it-reveals-about-congestive-heart-failure-readmissions
#18
Carl W Stevenson, Kattie Payne
PURPOSE OF STUDY: The medical record is a sea of information that can reveal what patients are trying to tell us about their health condition. It can reveal hints and trends as to why veterans with congestive heart failure (CHF) are being readmitted within 30 days after hospital discharge. These hints and trends lead caregivers to key contributing variables to veterans' readmission. Furthermore, these variables can be used to predict patient outcomes such as readmission and even prognosis...
January 2017: Professional Case Management
https://www.readbyqxmd.com/read/27901638/atlantic-dip-insulin-therapy-for-women-with-iadpsg-diagnosed-gestational-diabetes-mellitus-does-it-work
#19
D Bogdanet, A M Egan, C Reddin, O Kgosidialwa, B Kirwan, L Carmody, F P Dunne
INTRODUCTION: Approximately 40% of women with gestational diabetes mellitus (GDM) diagnosed using IADPSG criteria require insulin therapy. OBJECTIVE: To assess if the outcomes for women with GDM treated with insulin are comparable to women with normal glucose tolerance (NGT). MATERIALS AND METHODS: This retrospective cohort study included 752 women with insulin-treated GDM and 2496 women with NGT during pregnancy. Maternal and foetal outcomes were examined...
November 30, 2016: Journal of Clinical Endocrinology and Metabolism
https://www.readbyqxmd.com/read/27901516/psychotropic-drug-changes-contributing-to-readmissions-in-medically-hospitalized-psychiatric-patients-a-retrospective-study
#20
Subramoniam Madhusoodanan, Biling Xu, Srikanth Prayaga, Piotr Slowik, Ronald Brenner, Wallace Thomas, Natalie Schwartz
BACKGROUND: Psychotropic drug changes during medical hospitalizations may lead to psychiatric and medical readmissions. METHODS: One-year hospitalization records of nursing home patients with chronic mental illness and a psychotropic drug change during medical admission were reviewed. We calculated the readmission rates for 30, 60, and 90 days; the classes of the psychotropic drugs changed; the reason for change; and the specialties of the responsible physicians...
November 2016: Annals of Clinical Psychiatry: Official Journal of the American Academy of Clinical Psychiatrists
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