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https://www.readbyqxmd.com/read/29423184/postnatal-care-for-newborns-in-bangladesh-the-importance-of-health-related-factors-and-location
#1
Kavita Singh, Paul Brodish, Mahbub Elahi Chowdhury, Taposh Kumar Biswas, Eunsoo Timothy Kim, Christine Godwin, Allisyn Moran
Background: Bangladesh achieved Millennium Development Goal 4, a two thirds reduction in under-five mortality from 1990 to 2015. However neonatal mortality remains high, and neonatal deaths now account for 62% of under-five deaths in Bangladesh. The objective of this paper is to understand which newborns in Bangladesh are receiving postnatal care (PNC), a set of interventions with the potential to reduce neonatal mortality. Methods: Using data from the Bangladesh Maternal Mortality Survey (BMMS) 2010 we conducted logistic regression analysis to understand what socio-economic and health-related factors were associated with early postnatal care (PNC) by day 2 and PNC by day 7...
December 2017: Journal of Global Health
https://www.readbyqxmd.com/read/29401155/combined-nmda-inhibitor-use-in-a-patient-with-multisubstance-induced-psychotic-disorder
#2
Matteo Caloro, Giuseppa Calabrò, Eleonora de Pisa, Enrico Rosini, Georgios D Kotzalidis, Davide Lonati, Carlo Alessandro Locatelli, Pietro Papa, Fabrizio Schifano, Paolo Girardi
: Novel psychoactive substance use is a major social concern. Their use may elicit or uncover unpredictably as yet undescribed clinical pictures. We aimed to illustrate a multisubstance use case indistinguishable from paranoid schizophrenia, so to alert clinicians on possibly misdiagnosing substance-induced psychotic disorders. CASE REPORT: We describe a case of a 32-year-old man who started at 18 years with cannabinoids and ketamine, and is currently using N-methyl-D-aspartate (NMDA) antagonists...
February 2, 2018: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/29401054/impact-of-standardizing-management-of-atrial-fibrillation-with-rapid-heart-rate-in-the-emergency-department
#3
Ernesto De Leon, Lewei Duan, Ellen Rippenberger, Adam L Sharp
CONTEXT: There is substantial variation in the emergency treatment of atrial fibrillation with tachycardia. A standardized treatment approach at an academic center decreased admissions without adverse outcomes, but this approach has not been evaluated in a community Emergency Department (ED). OBJECTIVE: To evaluate the implementation of a standardized treatment guideline for patients with atrial fibrillation and a rapid heart rate in a community ED. DESIGN: An observational pre-/postimplementation (August 2013 to July 2014 and August 2014 to July 2015, respectively) study at a community ED...
2018: Permanente Journal
https://www.readbyqxmd.com/read/29397248/safety-and-feasibility-of-endovascular-aortic-aneurysm-repair-as-day-surgery
#4
Stephen C Hanley, Oren Steinmetz, Eva S Mathieu, Daniel Obrand, Kent Mackenzie, Marc-Michel Corriveau, Cherrie Z Abraham, Heather L Gill
OBJECTIVE: The adoption of endovascular aneurysm repair (EVAR) during the past two decades has led to significantly shorter length of stay as well as lower hospital resource use. Currently, most patients are admitted to the hospital after EVAR; however, there are no standard observation periods, and timing of discharge is based on clinical judgment. The aim of this study was to confirm the safety and feasibility of performing EVAR as outpatient surgery. METHODS: We developed criteria to identify patients for potential same-day discharge (infrarenal aneurysm, low perioperative risk, to be accompanied for first 24 hours)...
January 31, 2018: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/29387876/mortality-rates-after-the-first-diagnosis-of-psychotic-disorder-in-adolescents-and-young-adults
#5
Gregory E Simon, Christine Stewart, Bobbi Jo Yarborough, Frances Lynch, Karen J Coleman, Arne Beck, Belinda H Operskalski, Robert B Penfold, Enid M Hunkeler
Importance: Individuals with psychotic disorders have increased mortality, and recent research suggests a marked increase shortly after diagnosis. Objective: To use population-based data to examine overall and cause-specific mortality after first diagnosis of a psychotic disorder. Design, Setting, and Participants: This cohort study used records from 5 integrated health systems that serve more than 8 million members in 5 states. Members aged 16 through 30 years who received a first lifetime diagnosis of a psychotic disorder from September 30, 2009, through September 30, 2015, and 2 comparison groups matched for age, sex, health system, and year of diagnosis were selected from all members making an outpatient visit (general outpatient group) and from all receiving a first diagnosis of unipolar depression (unipolar depression group)...
January 31, 2018: JAMA Psychiatry
https://www.readbyqxmd.com/read/29384944/epidemiologic-characteristics-and-outcomes-of-major-trauma-patients-requiring-prolonged-mechanical-ventilation
#6
Shu-Chen Kung, Wei-Ting Lin, Tsung-Chih Tsai, Ming-Hsiu Lin, Chia-Hao Chang, Chih-Cheng Lai, Chien-Ming Chao
The epidemiologic characteristics and outcomes of severe trauma patients requiring prolonged mechanical ventilation (PMV) remain unclear. This retrospective study aims to investigate the outcomes of PMV in this specific group. All patients with major trauma admitted to the respiratory care center (RCC) requiring PMV (duration ≥21 days between January 2014 and December 2016) were enrolled. A total of 36343 trauma patients visited our emergency department for management, and 1388 (3.82%) were admitted to the intensive care unit (ICU) after initial resuscitation...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29379953/effect-of-an-in-hospital-multifaceted-clinical-pharmacist-intervention-on-the-risk-of-readmission-a-randomized-clinical-trial
#7
Lene Vestergaard Ravn-Nielsen, Marie-Louise Duckert, Mia Lolk Lund, Jolene Pilegaard Henriksen, Michelle Lyndgaard Nielsen, Christina Skovsende Eriksen, Thomas Croft Buck, Anton Pottegård, Morten Rix Hansen, Jesper Hallas
Importance: Hospital readmissions are common among patients receiving multiple medications, with considerable costs to the patients and society. Objective: To determine whether a multifaceted pharmacist intervention based on medication review, patient interview, and follow-up can reduce the number of readmissions and emergency department (ED) visits. Design, Setting, and Participants: This randomized clinical multicenter study (Odense Pharmacist Trial Investigating Medication Interventions at Sector Transfer [OPTIMIST]) enrolled patients from September 1, 2013, through April 23, 2015, with a follow-up of 6 months completed on October 31, 2015...
January 29, 2018: JAMA Internal Medicine
https://www.readbyqxmd.com/read/29356650/the-association-of-exposure-to-suicide-related-internet-content-and-emergency-department-visits-in-children-a-population-based-time-series-analysis
#8
Naveen Poonai, Shruti Mehrotra, Muhammad Mamdani, Anastasia Patmanidis, Michael Miller, Javeed Sukhera, Quynh Doan
OBJECTIVES: Suicide-related emergency department (ED) visits by children are increasing in tandem with suicide-related Internet content. Following the announcement of Amanda Todd's suicide, her YouTube video received widespread views, providing an opportunity to explore this association. METHODS: Our research question was: Among Ontario children age 11-17 years, was the release of Amanda Todd's YouTube video following her death announcement in October 2012 associated with an increase in average monthly ED visit rates for suicide-related diagnoses? We performed an interrupted time series analysis from April 2002 to December 2013, with the primary outcome as a composite of the average monthly rate of initial ED visits for suicidal ideation, intentional self-poisoning, and intentional self-harm...
January 22, 2018: Canadian Journal of Public Health. Revue Canadienne de Santé Publique
https://www.readbyqxmd.com/read/29310357/risk-profile-management-and-outcomes-of-patients-with-venous-thromboembolism-attended-in-spanish-emergency-departments-the-espheria-registry
#9
Sonia Jimenez, Pedro Ruiz-Artacho, Marta Merlo, Coral Suero, Albert Antolin, José Ramón Casal, Marta Sanchez, Alejandra Ortega-Duarte, Mar Genis, Pascual Piñera
The objective of this study was to determine the clinical profile of and diagnostic and therapeutic approach to patients with venous thromboembolism (VTE) in Spanish Emergency Departments (EDs). Risk factors, adherence to clinical practice guidelines, and outcomes were also evaluated.Patients with VTE diagnosed in 53 Spanish EDs were prospectively and consecutively included. Demographic data, comorbidities, risk factors for VTE, index event characteristics, hemorrhagic risk, and mortality were evaluated. Adherence to clinical practice guidelines was assessed based on clinical probability scales, requests for determination of D-dimer, use of anticoagulant treatment before confirmation of diagnosis, and assessment of bleeding and prognostic risk...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29250770/racial-disparities-in-hospice-outcomes-a-race-or-hospice-level-effect
#10
Jessica Rizzuto, Melissa D Aldridge
OBJECTIVES: To determine whether there is racial variation in hospice enrollees in rates of hospitalization and hospice disenrollment and, if so, whether systematic differences in hospice provider patterns explain the variation. DESIGN: Longitudinal cohort study. SETTING: Hospice. PARTICIPANTS: Medicare beneficiaries (N = 145,038) enrolled in a national random sample of hospices (N = 577) from the National Hospice Survey and followed until death (2009-10)...
December 18, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29247265/end-of-life-care-pathway-of-head-and-neck-cancer-patients-single-institution-experience
#11
T Heinonen, V Loimu, K Saarilahti, T Saarto, A Mäkitie
BACKGROUND: Studies on palliative care of head and neck cancer (HNC) patients are scarce although the affected patient population is quite large. OBJECTIVE: To evaluate the role of a specialised palliative-care pathway of HNC patients. PATIENTS AND METHODS: Data on all HNC patients who were treated at the Helsinki University Hospital Palliative Care Center during 1 year were retrospectively reviewed. The analysis comprised 60 patients (49 males; mean age 67 years; range 28-88)...
December 15, 2017: European Archives of Oto-rhino-laryngology
https://www.readbyqxmd.com/read/29241809/chemotherapy-use-end-of-life-care-and-costs-of-care-among-patients-diagnosed-with-stage-iv-pancreatic-cancer
#12
Yuhua Bao, Renee C Maciejewski, Melissa M Garrido, Manish A Shah, Paul K Maciejewski, Holly G Prigerson
CONTEXT: For patients with metastatic cancer and limited life-expectancy, potential benefits of chemotherapy must be balanced against harms to quality-of-life near death and increased out-of-pocket costs of care. OBJECTIVES: To evaluate the association between chemotherapy use by patients with Stage IV pancreatic cancer and health care use and Medicare and out-of-pocket costs in the last 30 days of life. METHODS: We conducted a retrospective, cohort study of 3,825 patients 66 years or older when diagnosed with Stage IV pancreatic cancer in 2006-2011, using the linked Surveillance, Epidemiology, and End Results (SEER)-Medicare data...
December 11, 2017: Journal of Pain and Symptom Management
https://www.readbyqxmd.com/read/29237710/short-term-outcomes-and-factors-associated-with-adverse-events-among-adults-discharged-from-the-emergency-department-after-treatment-for-acute-heart-failure
#13
MULTICENTER STUDY
Dana R Sax, Dustin G Mark, Renee Y Hsia, Thida C Tan, Grace H Tabada, Alan S Go
BACKGROUND: Although 80% of patients with heart failure seen in the emergency department (ED) are admitted, less is known about short-term outcomes and demand for services among discharged patients. METHODS AND RESULTS: We examined adult members of a large integrated delivery system who visited an ED for acute heart failure and were discharged from January 1, 2013, through September 30, 2014. The primary outcome was a composite of repeat ED visit, hospital admission, or death within 7 days of discharge...
December 2017: Circulation. Heart Failure
https://www.readbyqxmd.com/read/29224990/the-shift-to-same-day-outpatient-joint-arthroplasty-a-systematic-review
#14
REVIEW
Jeffrey D Hoffmann, Nicholas A Kusnezov, John C Dunn, Nicholas J Zarkadis, Gens P Goodman, Richard A Berger
BACKGROUND: Hip and knee arthroplasties length of stay continues to shorten after advances in perioperative and intraoperative management, as well as financial incentives. Some authors have demonstrated good results with outpatient arthroplasty, but safety and general feasibility of such procedures remain unclear. Our hypothesis is that outpatient arthroplasty would demonstrate higher readmission and complication rates than inpatient arthroplasty. METHODS: We performed a systematic review of all publications on outpatient arthroplasty between January 1, 2000 and June 1, 2016...
November 22, 2017: Journal of Arthroplasty
https://www.readbyqxmd.com/read/29220082/benefits-of-multimodal-enhanced-recovery-pathway-in-patients-undergoing-kidney-transplantation
#15
Kevin A Espino, J Reinier F Narvaez, Michael C Ott, Liise K Kayler
BACKGROUND: Use of enhanced recovery after surgery (ERAS) pathways to accelerate functional recovery and reduce length of stay (LOS) has rarely been investigated in kidney transplantation (KTX). MATERIALS AND METHODS: Consecutive adult isolated KTXs between July 2015 and July 2016 (ERAS, n = 139) were compared with a historical cohort between January 2014 and July 2015 (HISTORIC, n = 95). RESULTS: Enhanced recovery after surgery recipients were significantly more likely to receive kidneys that were non-local (56...
December 8, 2017: Clinical Transplantation
https://www.readbyqxmd.com/read/29202599/bereaved-parents-health-status-during-the-first-6-months-after-their-child-s-death
#16
Nancy Dias, Debra Brandon, Joan E Haase, Paula Tanabe
PURPOSE: To examine bereaved parents' physical, mental, and social health during the first 6 months after their child's (<12 years) death from a life-threatening illness. BACKGROUND AND SIGNIFICANCE: Bereaved parents have higher mortality and morbidity rates when compared to nonbereaved parents. Acute illnesses, hospitalizations, and medication changes are highest in the first 6 months. An understanding of bereaved parents' health risk indicators can help inform development of health promotion and disease prevention measures...
January 1, 2017: American Journal of Hospice & Palliative Care
https://www.readbyqxmd.com/read/29175877/the-feasibility-of-an-interactive-voice-response-system-ivrs-for-monitoring-patient-safety-after-discharge-from-the-ed
#17
Lisa A Calder, A Adam Cwinn, Mathieu Gatien, Andrew Gee, Natasha Larocque, Samantha Calder-Sprackman, Ria De Gorter, Jennifer Zlepnig, Ian G Stiell, Alan J Forster
BACKGROUND: Return ED visits are frequent and may be due to adverse events: adverse outcomes related to healthcare received. An interactive voice response system (IVRS) is a technology that translates human telephone input into digital data. Use of IVRS has been explored in many healthcare settings but to a limited extent in the ED. We determined the feasibility of using an IVRS to assess for adverse events after ED discharge. METHODS: This before and after study assessed detection of adverse events among consecutive high-acuity patients discharged from a tertiary care ED pre-IVRS and post-IVRS over two 2-week periods...
November 24, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/29159148/endovascular-treatment-of-symptomatic-vasospasm-after-aneurysmal-subarachnoid-hemorrhage-a-three-year-experience
#18
Eun-Sung Park, Dae-Won Kim, Sung-Don Kang
Objective: The cause of severe clinical vasospasm after aneurysmal subarachnoid hemorrhage remains unknown, despite extensive research over the past 30 years. However, the intra-arterial administration of vasodilating agents and balloon angioplasty have been successfully used in severe refractory cerebral vasospasm. Materials and Methods: We retrospectively analyzed the data of 233 patients admitted to our institute with aneurysmal subarachnoid hemorrhage (SAH) over the past 3 years...
September 2017: Journal of Cerebrovascular and Endovascular Neurosurgery
https://www.readbyqxmd.com/read/29153752/hospice-care-for-patients-with-dementia-in-the-united-states-a-longitudinal-cohort-study
#19
Aline De Vleminck, R Sean Morrison, Diane E Meier, Melissa D Aldridge
BACKGROUND: Patients with dementia form an increasing proportion of those entering hospice care. Little is known about the types of hospices serving patients with dementia and the patterns of hospice use, including timing of hospice disenrollment between patients with and without dementia. OBJECTIVES: To characterize the hospices that serve patients with dementia, to compare patterns of hospice disenrollment for patients with dementia and without dementia, and to evaluate patient-level and hospice-level characteristics associated with hospice disenrollment...
November 16, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29136314/syncope-prognosis-based-on-emergency-department-diagnosis-a-prospective-cohort-study
#20
Cristian Toarta, Muhammad Mukarram, Kirtana Arcot, Soo-Min Kim, Sarah Gaudet, Marco L A Sivilotti, Brian H Rowe, Venkatesh Thiruganasambandamoorthy
OBJECTIVE: Relatively little is known about outcomes after disposition among syncope patients assigned various diagnostic categories during emergency department (ED) evaluation. We sought to measure the outcomes among these groups within 30 days of the initial ED visit. METHODS: We prospectively enrolled adult syncope patients at six EDs and excluded patients with presyncope, persistent mental status changes, intoxication, seizure, and major trauma. Patient characteristics, ED management, diagnostic impression (presumed vasovagal, orthostatic, cardiac, or other/unknown) at the end of the ED visit, and physicians' confidence in assigning the etiology were collected...
November 14, 2017: Academic Emergency Medicine: Official Journal of the Society for Academic Emergency Medicine
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