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https://www.readbyqxmd.com/read/28641392/alcohol-is-not-protective-against-mortality-following-traumatic-brain-injury
#1
Jennifer S Albrecht, Majid Afshar, Deborah M Stein, Gordon S Smith
Alcohol exposure results in reduced mortality following traumatic brain injury (TBI) in animal models, yet clinical studies reported conflicting results and clinical trials based on proposed mechanisms have been disappointing. Methodological issues common to many of the clinical studies may have contributed to spurious results. Our objective was to evaluate the association between blood alcohol concentration (BAC) and in-hospital mortality following TBI, overcoming methodological problems of prior studies. We conducted a retrospective cohort study on individuals treated for isolated TBI at the R Adams Cowley Shock Trauma Center between 1997-2012 (n = 1,084)...
June 21, 2017: American Journal of Epidemiology
https://www.readbyqxmd.com/read/28641385/development-of-an-electronic-medical-record-based-child-physical-abuse-alert-system
#2
Rachel P Berger, Richard A Saladino, Janet Fromkin, Emily Heineman, Srinivasan Suresh, Tom McGinn
Objective: Physical abuse is a leading cause of pediatric morbidity and mortality. Physicians do not consistently screen for abuse, even in high-risk situations. Alerts in the electronic medical record may help improve screening rates, resulting in early identification and improved outcomes. Methods: Triggers to identify children < 2 years old at risk for physical abuse were coded into the electronic medical record at a freestanding pediatric hospital with a level 1 trauma center...
June 21, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28641379/clinical-events-preceding-switching-and-discontinuation-of-oral-anticoagulant-treatment-in-patients-with-atrial-fibrillation
#3
Maja Hellfritzsch, Erik Lerkevang Grove, Steen Elkjær Husted, Lotte Rasmussen, Birgitte Klindt Poulsen, Søren Paaske Johnsen, Jesper Hallas, Anton Pottegård
Aims: Switching between oral anticoagulants and treatment discontinuation are common events related to therapy with non-vitamin K antagonist oral anticoagulants (NOACs). However, knowledge on the reasons leading to these treatment changes is scarce. The aim of this study was to identify clinical events preceding anticoagulant switching and NOAC discontinuation during oral anticoagulant therapy in patients with atrial fibrillation. Methods and results: We performed a nationwide register-based study including Danish atrial fibrillation patients initiating a NOAC between August 2011 and February 2016 (n = 50 623)...
October 17, 2016: Europace: European Pacing, Arrhythmias, and Cardiac Electrophysiology
https://www.readbyqxmd.com/read/28641357/-the-german-thorax-registry-implementation-of-an-established-tool-of-perioperative-health-care-research
#4
Jérôme Defosse, Mark Schieren, Torsten Loop, Cerstin Arndt, Rainer Röhrig, Erich Stoelben, Corinna Ludwig, Alexander Schleppers, Frank Wappler, Mark Gerbershagen, Alberto Lopez-Pastorini
The collection of clinical treatment data in registry databases is an important aspect of health services research. It allows for a critical evaluation of the safety, efficacy and cost-effectiveness of clinical treatment concepts in large patient populations. The findings of registry research represent real-world patients and treatment structures as they are not limited by strict inclusion criteria or unrealistic conditions as applied in prospective clinical trials. The implementation of the German Thorax Registry has enabled the collection and analysis of data on the interdisciplinary care (thoracic surgery, anaesthesiology, intensive care, pain management) of patients undergoing thoracic surgery...
June 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28641352/-do-general-surgeons-feel-adequately-prepared-for-the-complex-questions-associated-with-the-handling-of-multi-resistant-pathogens-results-of-the-mr2-survey
#5
Matthias May, Philipp J Spachmann, Steffen Lebentrau, Harald Schumacher, Christian Gilfrich, Hans-Martin Fritsche, Malte Vetterlein, Sabine Brookman-May, Martin Schostak, Florian M Wagenlehner, Maximilian Burger, Alexander Novotny, Robert Obermaier
Background At the present time, there is no evidence available as to the knowledge of general surgeons regarding multi-resistant pathogens (MRP) and the rational use of antibiotic medication (antibiotic stewardship/ABS) compared with physicians from other disciplines. Methods As part of the MR2 survey (Multiinstitutional Reconnaissance of practice with MultiResistant bacteria - a survey focussing on German hospitals), a questionnaire comprising 4 + 35 items was distributed to urologists, internists, gynaecologists and general surgeons in 18 hospitals...
June 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28641331/-surgical-treatment-of-pseudotumours-of-the-lung
#6
Zsolt Sziklavari, Annete Droste, Reiner Neu, Hans-Stefan Hofmann, Michael Ried
Introduction Pseudotumour of the lung is a collective term for various subentities. Some subgroups are considered to be intermediary malignant tumours. A pseudotumour is a rare condition, which makes it difficult to estimate its incidence and prevalence. Methods Retrospective analysis of all surgically treated patients between 2008 and 2015 diagnosed with a pseudotumour of the lung. The primary endpoint of this study was to estimate the rates of local recurrence and metastasis. Secondary endpoints were to determine the nomenclature, medical history, treatment, and the perioperative course...
June 22, 2017: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/28641321/identifying-and-acting-on-potentially-inappropriate-care-inadequacy-of-current-hospital-coding-for-this-task
#7
P David Cooper, David R Smart
INTRODUCTION: Recent Australian attempts to facilitate disinvestment in healthcare, by identifying instances of 'inappropriate' care from large Government datasets, are subject to significant methodological flaws. Amongst other criticisms has been the fact that the Government datasets utilized for this purpose correlate poorly with datasets collected by relevant professional bodies. Government data derive from official hospital coding, collected retrospectively by clerical personnel, whilst professional body data derive from unit-specific databases, collected contemporaneously with care by clinical personnel...
June 2017: Diving and Hyperbaric Medicine: the Journal of the South Pacific Underwater Medicine Society
https://www.readbyqxmd.com/read/28641305/incidence-of-autoimmune-myasthenia-gravis-in-a-health-maintenance-organization-in-buenos-aires-argentina
#8
Mariela Bettini, Marcelo Chaves, Edgardo Cristiano, Vanina Pagotto, Lucia Perez, Diego Giunta, Marcelo Rugiero
BACKGROUND: Different epidemiological studies, especially in Europe, have estimated the incidence density of myasthenia gravis (MG) to range between 1.7 and 21.3/1,000,000/person-year; however, data from regions such as Latin America are scarce. This study is aimed at estimating the incidence and prevalence of acquired MG in Buenos Aires, Argentina. METHODS: The study population comprised of affiliates of the Italian Hospital Medical Care Program, a prepaid health maintenance organization located in Buenos Aires...
June 23, 2017: Neuroepidemiology
https://www.readbyqxmd.com/read/28641304/hyperemesis-gravidarum-a-review-of-recent-literature
#9
Viktoriya London, Stephanie Grube, David M Sherer, Ovadia Abulafia
BACKGROUND: In the United States, hyperemesis gravidarum is the most common cause of hospitalization during the first half of pregnancy and is second only to preterm labor for hospitalizations in pregnancy overall. In approximately 0.3-3% of pregnancies, hyperemesis gravidarum is prevalent and this percentage varies on account of different diagnostic criteria and ethnic variation in study populations. Despite extensive research in this field, the mechanism of the disease is largely unknown...
June 23, 2017: Pharmacology
https://www.readbyqxmd.com/read/28641292/the-incidence-clinical-significance-and-treatment-effects-of-depression-in-cardiac-resynchronization-therapy-recipients
#10
Tomasz Podolecki, Robert Pudlo, Michal Mazurek, Monika Koziel, Ewa Jedrzejczyk-Patej, Joanna Boidol, Katarzyna Przybylska, Adam Sokal, Oskar Kowalski, Jacek Kowalczyk, Radoslaw Lenarczyk, Zbigniew Kalarus
OBJECTIVES: Chronic heart failure (HF) is associated with significantly increased prevalence of depression. The aim of the study was to assess the incidence and clinical impact of depression as well as the effectiveness of depression treatment in HF patients. METHODS: A prospective interventional trial included 285 consecutive cardiac resynchronization therapy recipients. Patients underwent a psychiatric examination at the time of implantation and then it was routinely repeated at 3, 6, and 12 months after the procedure, and every 6 months thereafter...
June 23, 2017: Cardiology
https://www.readbyqxmd.com/read/28641289/impact-of-comorbid-irritable-bowel-syndrome-on-treatment-outcome-in-non-erosive-reflux-disease-on-long-term-proton-pump-inhibitor-in-japan
#11
Yasushi Funaki, Hiroshi Kaneko, Yurika Kawamura, Takashi Yoshimine, Yasuhiro Tamura, Shinya Izawa, Masahide Ebi, Naotaka Ogasawara, Makoto Sasaki, Kunio Kasugai
BACKGROUND/AIMS: Irritable bowel syndrome (IBS) frequently coexists with non-erosive reflux disease (NERD). Efficacy of long-term proton pump inhibitor (PPI) treatment on NERD with or without IBS is controversial. The impact of comorbid IBS in NERD on quality of life (QOL) remains uncertain. We verified the hypothesis that NERD patients with IBS symptoms demonstrated poor responses to long-term PPI treatments, deteriorated QOL, and high frequency of psychological deviations in Japan. METHODS: In all, 141 NERD patients who had been taking PPIs for more than 6 months were enrolled and analyzed...
June 23, 2017: Digestion
https://www.readbyqxmd.com/read/28641281/complementary-and-alternative-medicine-a-clinical-study-in-1-016-hematology-oncology-patients
#12
Marina Hierl, Jochen Pfirstinger, Reinhard Andreesen, Ernst Holler, Stephanie Mayer, Daniel Wolff, Martin Vogelhuber
INTRODUCTION: Surveys state a widespread use of complementary and alternative medicine (CAM) in patients with malignant diseases. CAM methods might potentially interfere with the metabolization of tumor-specific therapy. However, there is little communication about CAM use in hematology/oncology patients between patients, CAM providers, and oncologists. PATIENTS AND METHODS: A self-administered questionnaire was handed out to all patients attending to the hematology/oncology outpatient clinic of Regensburg University Hospital...
June 23, 2017: Oncology
https://www.readbyqxmd.com/read/28641275/a-case-series-of-surgically-diagnosed-idiopathic-aortitis-in-a-canadian-centre-a-retrospective-study
#13
Diane L Murzin, Eric C Belanger, John P Veinot, Nataliya Milman
BACKGROUND: Idiopathic aortitis became recognized relatively recently, and the body of knowledge concerning this condition is scarce. We aimed to determine the frequency of idiopathic aortitis in aortic specimens, the clinical, laboratory and radiologic characteristics at diagnosis and during follow-up, and the approach to investigation, treatment and monitoring taken by the treating physicians. METHODS: We identified cases of aortitis diagnosed on pathological specimens of the aorta between Jan...
June 19, 2017: CMAJ Open
https://www.readbyqxmd.com/read/28641231/association-between-timing-of-intubation-and-outcome-in-critically-ill-patients-a-secondary-analysis-of-the-icon-audit
#14
Philippe R Bauer, Ognjen Gajic, Rahul Nanchal, Rahul Kashyap, Ignacio Martin-Loeches, Yasser Sakr, Stephan M Jakob, Bruno François, Xavier Wittebole, Richard G Wunderink, Jean-Louis Vincent
PURPOSE: The optimal timing of endotracheal intubation in critically ill patients requiring invasive mechanical ventilation remains undefined. MATERIAL AND METHODS: In a secondary analysis of the large, prospective ICON database, we used a piecewise proportional hazards model to compare outcomes in patients who underwent intubation early (within two days after intensive care unit [ICU] admission) or later. RESULTS: After excluding 5340 patients already intubated on admission or with therapeutic limitation, 4729 patients were analyzed, of whom 4074 never underwent intubation...
June 16, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28641170/efficacy-and-safety-of-eslicarbazepine-acetate-monotherapy-for-partial-onset-seizures-experience-from-a-multicenter-observational-study
#15
Rafael Toledano, Camilo Espinosa Jovel, Adolfo Jiménez-Huete, Pau Giner Bayarri, Dulce Campos, Elena López Gomariz, Beatriz González Giráldez, Irene García-Morales, Mercé Falip, Paula Martínez Agredano, Susana Palao, María José Aguilar Amat Prior, María Rosa Querol Pascual, Francisco José Navacerrada, Francisco Javier López González, Joaquín Ojeda, Aránzazu Alfaro Sáez, Pedro Emilio Bermejo, Antonio Gil-Nagel
Eslicarbazepine acetate (ESL, Aptiom™) is a once-daily anticonvulsant, approved as adjunctive treatment of partial-onset seizures (POS). Historical-controlled trials investigating the use of ESL as monotherapy have demonstrated a favorable efficacy and tolerability profile in patients with POS. This prospective, non-interventional study recruited POS patients in 17 hospitals in Spain. After a 3-month baseline period, ESL therapy was initiated as 400mg QD and up-titrated to an optimal maintenance dose based on clinical response and tolerance...
June 19, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28641169/association-between-switching-antiepileptic-drug-products-and-healthcare-utilization-a-systematic-review
#16
REVIEW
Patrick Kwan, André Palmini
AIMS: There is ongoing concern whether switching between different antiepileptic drug (AED) products may compromise patient care. We systematically reviewed changes in healthcare utilization following AED switch. METHODS: We searched MEDLINE and EMBASE databases (1980-October 2016) for studies that assessed the effect of AED switching in patients with epilepsy on outpatient visits, emergency room visits, hospitalization and hospital stay duration. RESULTS: A total of 14 articles met the inclusion criteria...
June 19, 2017: Epilepsy & Behavior: E&B
https://www.readbyqxmd.com/read/28641098/trends-in-hematopoietic-stem-cell-transplant-activity-in-lebanon
#17
REVIEW
Ali Bazarbachi, Ammar Zahreddine, Radwan Massoud, Jean Cheikh, Colette Hanna, Fadi Nasr, Miguel Abboud, Ahmad Ibrahim
Hematopoietic stem cell transplantation (HSCT) has been accessible to the population residing in Lebanon and surrounding countries since 1997. HSCT programs were developed in two major hospitals in Beirut: American University of Beirut Medical Center (AUBMC) and Makassed General Hospital. Mount Lebanon Hospital initiated an autologous HSCT activity later. Between 2012 and 2016, the HSCT activity in Lebanon reached a total of 897 transplants, among which 303 (33.8%) were allogeneic HSCT and 594 (66.2%) were autologous HSCT...
June 13, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28641091/increasing-rates-of-clostridium-difficile-infection-in-mexican-hospitals
#18
Laura Palau Dávila, Elvira Garza-González, Patricia Rodríguez-Zulueta, Rayo Morfín-Otero, Eduardo Rodríguez-Noriega, Diana Villar-Compte, Juan C Rodríguez-Aldama, Adrián Camacho-Ortiz
INTRODUCTION: The epidemiology of Clostridium difficile infection (CDI) has changed in the last two decades. There is a lack of information regarding incidence and severity of CDI, especially in the developing world. METHODS: This was a retrospective and observational study from four hospitals of three Mexican cities. Patients were diagnosed with CDI when presented with loose stools and had at least one of the following tests positive: toxins assay, real-time PCR, or an endoscopic image compatible with pseudomembranous colitis...
June 19, 2017: Brazilian Journal of Infectious Diseases
https://www.readbyqxmd.com/read/28641035/hypoglycemia-patients-and-transport-by-ems-in-alameda-county-2013-15
#19
Howard H Moffet, E Margaret Warton, Lee Siegel, Karl Sporer, Kasia J Lipska, Andrew J Karter
OBJECTIVE: To estimate the rate, characteristics, and dispositions of hypoglycemia events among persons who received care from Alameda County, California, Emergency Medical Services (EMS). METHODS: This study was based on data for 601,077 Alameda County EMS encounters during 2013-15. Subjects were defined as having hypoglycemia if EMS personnel recorded a primary impression of hypoglycemia or low blood glucose (<60 mg/dl or "unspecified low"). The outcome of interest was patient transport or non-transport to an emergency department or other care setting; we excluded 33,177 (6%) encounters which lacked clear disposition outcomes...
June 22, 2017: Prehospital Emergency Care
https://www.readbyqxmd.com/read/28641027/effect-of-an-educational-intervention-in-spirituality-and-health-on-knowledge-attitudes-and-skills-of-students-in-health-related-areas-a-controlled-randomized-trial
#20
Igraíne Helena Scholz Osório, Lídia Maria Gonçalves, Pedro Machry Pozzobon, Jair José Gaspar Júnior, Filippe Martins Miranda, Alessandra L G Lucchetti, Giancarlo Lucchetti
BACKGROUND: To date there have been no randomized studies that assess whether "Spirituality and Health" (S/H) programs are, indeed, effective, or not. We sought to evaluate if an intervention in teaching S/H fosters competence changes in healthcare students. METHODS: A randomized controlled trial was carried out. Students were randomized into two groups: an Intervention Group (a theoretical-practical course in S/H) and a control group (waiting list). Students' S/H knowledge, attitudes, and skills (through a simulated patient) were assessed...
June 22, 2017: Medical Teacher
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