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https://www.readbyqxmd.com/read/27609207/partial-and-no-recovery-from-delirium-after-hospital-discharge-predict-increased-adverse-events
#1
Martin G Cole, Jane McCusker, Robert Bailey, Michael Bonnycastle, Shek Fung, Antonio Ciampi, Eric Belzile
BACKGROUND: the implications of partial and no recovery from delirium after hospital discharge are not clear. We sought to explore whether partial and no recovery from delirium among recently discharged patients predicted increased adverse events (emergency room visits, hospitalisations, death) during the subsequent 3 months. METHOD: prospective study of recovery from delirium in older hospital inpatients. The Confusion Assessment Method was used to diagnose delirium in hospital and determine recovery status after discharge (T0)...
September 8, 2016: Age and Ageing
https://www.readbyqxmd.com/read/27488754/post-discharge-heart-failure-monitoring-program-in-turkey-hit-point
#2
Yüksel Çavuşoğlu, Mehdi Zoghi, Mehmet Eren, Evin Bozçalı, Güliz Kozdağ, Tunay Şentürk, Güray Alicik, Korhan Soylu, İbrahim Sarı, Rida Berilgen, Ahmet Temizhan, Erkan Gencer, Ahmet Lütfü Orhan, Veli Polat, Aysel Aydın Kaderli, Meryem Aktoz, Halit Zengin, Mehmet Aksoy, Mehmet Timur Selçuk, Oktay Ergene, Özlem Soran
OBJECTIVE: The aim of this study was to assess the efficacy and feasibility of an enhanced heart failure (HF) education with a 6-month telephone follow- up program in post-discharge ambulatory HF patients. METHODS: The Hit-Point trial was a multicenter, randomized, controlled trial of enhanced HF education with a 6-month telephone follow-up program (EHFP) vs routine care (RC) in patients with HF and reduced ejection fraction. A total of 248 patients from 10 centers in various geographical areas were randomized: 125 to EHFP and 123 to RC...
July 26, 2016: Anatolian Journal of Cardiology
https://www.readbyqxmd.com/read/27271767/long-term-cardiovascular-outcomes-and-overall-survival-of-early-stage-breast-cancer-patients-with-early-discontinuation-of-trastuzumab-a-population-based-study
#3
Inna Y Gong, Sunil Verma, Andrew T Yan, Dennis T Ko, Craig C Earle, George A Tomlinson, Maureen E Trudeau, Murray D Krahn, Monika K Krzyzanowska, Christine B Brezden-Masley, Scott Gavura, Stuart Peacock, Kelvin K W Chan
We critically examined long-term cardiovascular (CV) outcomes and overall survival (OS) of breast cancer (BC) patients who had cardiotoxicity during adjuvant trastuzumab treatment requiring discontinuation in a population-based sample. This was a retrospective cohort of early-stage BC patients diagnosed before 2010 and treated with trastuzumab in Ontario. Patients were stratified based on trastuzumab doses received: 1-8, 9-15, ≥16 (therapy completion). Time-dependent multivariable Cox models were used to analyze primary endpoint OS, and the following composite endpoints: hospitalization/emergency room visit for heart failure (HF) or death; non-HF CV (myocardial infarction, stroke) or death; and clinically significant relapse (palliative systemic therapy initiation >90 days after last trastuzumab dose) or death...
June 2016: Breast Cancer Research and Treatment
https://www.readbyqxmd.com/read/27162127/the-efficacy-of-a-supervised-exercise-training-programme-on-readmission-rates-in-patients-with-myocardial-ischemia-results-from-a-randomised-controlled-trial
#4
Núria Santaularia, Josefina Caminal, Anna Arnau, Montserrat Perramon, Jesus Montesinos, Montserrat Abenoza Guardiola, Tiny Jaarsma
BACKGROUND: The results of research into the outcomes of physical rehabilitation and its relationship with post-myocardial ischaemia survival and readmissions are inconclusive. Our primary aim was to evaluate the efficacy of a supervised exercise training programme in terms of decreasing hospital cardiac readmission in patients with myocardial ischaemia. METHODS: We conducted a randomised controlled trial including patients with myocardial ischaemia. Eligible patients were assigned to a control group receiving standard care or to an intervention group that took part in a supervised exercise training programme...
May 9, 2016: European Journal of Cardiovascular Nursing
https://www.readbyqxmd.com/read/27134158/management-of-infections-in-critically-ill-returning-travellers-in-the-intensive-care-unit-i-considerations-on-infection-control-and-transmission-of-resistance
#5
REVIEW
Hakan Leblebicioglu, Alfonso J Rodriguez-Morales, Gian Maria Rossolini, Rogelio López-Vélez, Jean-Ralph Zahar, Jordi Rello
Depending on their destinations and activities, international travellers are at a significant risk of contracting both communicable and non-communicable diseases. On return to their home countries, such travellers may require intensive care. The emergence of severe acute respiratory syndrome coronavirus (SARS-CoV) and Middle East respiratory syndrome coronavirus (MERS-CoV), and more recently Ebola haemorrhagic fever, has highlighted the risks. Other well-known communicable pathogens such as methicillin-resistant Staphylococcus aureus and carbapenemase-producing Enterobacteriaceae have been described previously...
July 2016: International Journal of Infectious Diseases: IJID
https://www.readbyqxmd.com/read/27098330/the-safety-of-hand-and-upper-extremity-surgical-procedures-at-a-freestanding-ambulatory-surgery-center-a-review-of-28-737-cases
#6
REVIEW
Kanu S Goyal, Sameer Jain, Glenn A Buterbaugh, Joseph E Imbriglia
BACKGROUND: More procedures are being completed on an outpatient basis at freestanding ambulatory surgery centers. The purpose of our study was to determine the safety and rate of adverse events in outpatient hand and upper-extremity surgical procedures. METHODS: A retrospective review of cases at a single, freestanding ambulatory surgery center over an eleven-year period was performed. In our analysis, 28,737 cases were performed and were included. Adverse events were defined as serious complications causing harm to a patient or leading to additional treatment...
April 20, 2016: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/27091417/palliative-chemotherapy-affects-aggressiveness-of-end-of-life-care
#7
Chin-Chia Wu, Ta-Wen Hsu, Chun-Ming Chang, Cheng-Hung Lee, Chih-Yuan Huang, Ching-Chih Lee
INTRODUCTION: Although palliative chemotherapy during end-of-life care is used for relief of symptoms in patients with metastatic cancer, chemotherapy may lead to more aggressive end-of-life care and less use of hospice service. This is a population-based study of the association between palliative chemotherapy and aggressiveness of end-of-life care. PATIENTS AND METHODS: Using the National Health Insurance Research Database of Taiwan, we identified 49,920 patients with metastatic cancer who underwent palliative chemotherapy from January 1, 2009, to December 31, 2011...
June 2016: Oncologist
https://www.readbyqxmd.com/read/27037030/long-term-outcomes-and-healthcare-utilization-following-critical-illness-a-population-based-study
#8
A D Hill, R A Fowler, R Pinto, M S Herridge, B H Cuthbertson, D C Scales
BACKGROUND: The purpose of this study was to examine hospital mortality, long-term mortality, and health service utilization among critically ill patients. We also determined whether these outcomes differed according to demographic and clinical characteristics. METHODS: We conducted a retrospective cohort study of adults (age ≥ 18 years) who survived admission to an intensive care unit (ICU) in Ontario, Canada, between 1 April 2002 and 31 March 2012, excluding isolated admissions to step-down or intermediate ICUs, coronary care ICUs, or cardiac surgery ICUs...
2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/26863684/can-cluster-boosted-regression-improve-prediction-death-and-length-of-stay-in-the-icu
#9
Mahsa Rouzbahman, Aleksandra Jovicic, Mark Chignell
Sharing of personal health information is subject to multiple constraints, which may dissuade some organizations from sharing their data. Summarized de-identified data, such as that derived from k-means cluster analysis, is subject to far fewer privacy-related constraints. In this paper, we examine the extent to which analysis of clustered patient types can match predictions made by analyzing the entire dataset at once. After reviewing relevant literature, and explaining how data is summarized in each cluster of similar patients, we compare the results of predicting death, and length of stay in the ICU1 using regression analysis on original and clustered data from the MIMIC II dataset...
February 3, 2016: IEEE Journal of Biomedical and Health Informatics
https://www.readbyqxmd.com/read/26387928/a-clinical-decision-instrument-for-30-day-death-after-an-emergency-department-visit-for-atrial-fibrillation-the-atrial-fibrillation-in-the-emergency-room-after-study
#10
Clare L Atzema, Paul Dorian, Jiming Fang, Jack V Tu, Douglas S Lee, Alice S Chong, Peter C Austin
STUDY OBJECTIVE: The high volume of patients treated in an emergency department (ED) for atrial fibrillation is predicted to increase significantly in the next few decades. Currently, 11% of these patients die within a year. We sought to derive and validate a complex model and a simplified model that predicts mortality in ED patients with atrial fibrillation. METHODS: This population-based, retrospective cohort study included 3,510 adult patients with a primary diagnosis of atrial fibrillation who were treated at 24 hospital EDs in Ontario, Canada, between April 2008 and March 2009...
December 2015: Annals of Emergency Medicine
https://www.readbyqxmd.com/read/26207149/trends-in-mortality-associated-with-opening-of-a-full-capacity-public-emergency-department-at-the-main-tertiary-level-hospital-in-tanzania
#11
Hendry R Sawe, Juma A Mfinanga, Victor Mwafongo, Teri A Reynolds, Michael S Runyon
BACKGROUND: Emergency medicine is an emerging specialty in Sub-Saharan Africa, and most hospitals do not have a fully functional emergency department (ED). We describe the mortality rates of the Muhimbili National Hospital (MNH) in Dar es Salaam, Tanzania before and after the opening of a full-capacity ED. METHODS: This retrospective study investigated ED and hospital mortality rates for patients admitted to MNH from January 2008 to January 2012. This period represents 2 years before and 2 years after the opening of the full-capacity ED in January 2010...
2015: International Journal of Emergency Medicine
https://www.readbyqxmd.com/read/26063318/effect-of-shenzhu-guanxin-recipe-on-patients-with-angina-pectoris-after-percutaneous-coronary-intervention-a-prospective-randomized-controlled-trial
#12
RANDOMIZED CONTROLLED TRIAL
Dan-Ping Xu, Huan-Lin Wu, Tao-Hua Lan, Xia Wang, Xiao-Gang Sheng, Yu Lin, Song Li, Chao-Yang Zheng
OBJECTIVE: To evaluate the efficacy and safety of a combination therapy using Chinese medicine (CM) Shenzhu Guanxin Recipe (, SGR) and standard Western medicine treatment (SWMT) in patients with angina pectoris after percutaneous coronary intervention (PCI). METHODS: Double-blind randomized controlled trial was used in this experimental procedure. One hundred and eighty-seven patients with coronary heart disease receiving SWMT after PCI were randomly assigned to the treatment (SGR) and control (placebo) groups...
June 2015: Chinese Journal of Integrative Medicine
https://www.readbyqxmd.com/read/26028120/methadone-continuation-versus-forced-withdrawal-on-incarceration-in-a-combined-us-prison-and-jail-a-randomised-open-label-trial
#13
RANDOMIZED CONTROLLED TRIAL
Josiah D Rich, Michelle McKenzie, Sarah Larney, John B Wong, Liem Tran, Jennifer Clarke, Amanda Noska, Manasa Reddy, Nickolas Zaller
BACKGROUND: Methadone is an effective treatment for opioid dependence. When people who are receiving methadone maintenance treatment for opioid dependence are incarcerated in prison or jail, most US correctional facilities discontinue their methadone treatment, either gradually, or more often, abruptly. This discontinuation can cause uncomfortable symptoms of withdrawal and renders prisoners susceptible to relapse and overdose on release. We aimed to study the effect of forced withdrawal from methadone upon incarceration on individuals' risk behaviours and engagement with post-release treatment programmes...
July 25, 2015: Lancet
https://www.readbyqxmd.com/read/25800768/early-versus-delayed-initiation-of-concurrent-palliative-oncology-care-patient-outcomes-in-the-enable-iii-randomized-controlled-trial
#14
RANDOMIZED CONTROLLED TRIAL
Marie A Bakitas, Tor D Tosteson, Zhigang Li, Kathleen D Lyons, Jay G Hull, Zhongze Li, J Nicholas Dionne-Odom, Jennifer Frost, Konstantin H Dragnev, Mark T Hegel, Andres Azuero, Tim A Ahles
PURPOSE: Randomized controlled trials have supported integrated oncology and palliative care (PC); however, optimal timing has not been evaluated. We investigated the effect of early versus delayed PC on quality of life (QOL), symptom impact, mood, 1-year survival, and resource use. PATIENTS AND METHODS: Between October 2010 and March 2013, 207 patients with advanced cancer at a National Cancer Institute cancer center, a Veterans Affairs Medical Center, and community outreach clinics were randomly assigned to receive an in-person PC consultation, structured PC telehealth nurse coaching sessions (once per week for six sessions), and monthly follow-up either early after enrollment or 3 months later...
May 1, 2015: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/25696430/cost-effectiveness-of-eplerenone-plus-standard-treatment-compared-with-standard-treatment-in-patients-with-myocardial-infarction-complicated-by-left-ventricular-systolic-dysfunction-and-heart-failure-in-the-netherlands
#15
M L L van Genugten, W S Weintraub, Z Zhang, A A Voors
AIMS: Following the results of the EPHESUS study in patients with heart failure after myocardial infarction, a cost-effectiveness analysis was undertaken from a Dutch societal perspective to evaluate the lifetime benefits and costs of eplerenone as add-on to standard treatment. METHODS: Life-years gained in the eplerenone arm during the trial period were extrapolated to lifetime life-years gained using three sources of life expectancy data (Framingham Heart Study, Saskatchewan Health Database and Worcester Heart Attack Registry)...
November 2005: Netherlands Heart Journal
https://www.readbyqxmd.com/read/25657582/neuroinflammatory-responses-to-traumatic-brain-injury-etiology-clinical-consequences-and-therapeutic-opportunities
#16
REVIEW
Diego Lozano, Gabriel S Gonzales-Portillo, Sandra Acosta, Ike de la Pena, Naoki Tajiri, Yuji Kaneko, Cesar V Borlongan
Traumatic brain injury (TBI) is a serious public health problem accounting for 1.4 million emergency room visits by US citizens each year. Although TBI has been traditionally considered an acute injury, chronic symptoms reminiscent of neurodegenerative disorders have now been recognized. These progressive neurodegenerative-like symptoms manifest as impaired motor and cognitive skills, as well as stress, anxiety, and mood affective behavioral alterations. TBI, characterized by external bumps or blows to the head exceeding the brain's protective capacity, causes physical damage to the central nervous system with accompanying neurological dysfunctions...
2015: Neuropsychiatric Disease and Treatment
https://www.readbyqxmd.com/read/25549062/out-of-range-international-normalized-ratio-values-and-healthcare-cost-among-new-warfarin-patients-with-non-valvular-atrial-fibrillation
#17
Winnie W Nelson, Li Wang, Onur Baser, C V Damaraju, Jeffrey R Schein
BACKGROUND: Patients with out-of-range international normalized ratio (INR) values <2.0 and >3.0 have been associated with increased risk of thromboembolic and bleeding events. INR monitoring is costly, because of associated physician and nurse time, laboratory resource use, and dose adjustments. OBJECTIVES: This study assessed the healthcare cost burden associated with out-of-range INR among warfarin initiator patients diagnosed with non-valvular atrial fibrillation (NVAF) in the US Veterans Health Administration (VHA) population...
May 2015: Journal of Medical Economics
https://www.readbyqxmd.com/read/25516915/clinical-outcomes-after-parathyroidectomy-in-a-nationwide-cohort-of-patients-on-hemodialysis
#18
Areef Ishani, Jiannong Liu, James B Wetmore, Kimberly A Lowe, Thy Do, Brian D Bradbury, Geoffrey A Block, Allan J Collins
BACKGROUND AND OBJECTIVES: Patients receiving dialysis undergo parathyroidectomy to improve laboratory parameters in resistant hyperparathyroidism with the assumption that clinical outcomes will also improve. However, no randomized clinical trial data demonstrate the benefits of parathyroidectomy. This study aimed to evaluate clinical outcomes up to 1 year after parathyroidectomy in a nationwide sample of patients receiving hemodialysis. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Using data from the US Renal Data System, this study identified prevalent hemodialysis patients aged ≥18 years with Medicare as primary payers who underwent parathyroidectomy from 2007 to 2009...
January 7, 2015: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/25443144/commentary-on-the-burden-of-depression-in-prostate-cancer-jayadevappa-r-malkowicz-sb-chhatre-s-johnson-jc-gallo-jj-department-of-medicine-university-of-pennsylvania-school-of-medicine-philadelphia-pa-psychooncology-2012-21-12-1338-45-epub-2011-aug-12-doi-10
#19
COMMENT
Brent K Hollenbeck
OBJECTIVE: We sought to analyze the prevalence and incremental burden of depression among elderly with prostate cancer. METHODS: We adopted a retrospective cohort design using the Surveillance, Epidemiology and End Results-Medicare linked database between 1995 and 2003. Patients with prostate cancer diagnosed between 1995 and 1998 were identified and followed retrospectively for 1 year pre-diagnosis and up to 8 years post diagnosis. In this cohort of patients with prostate cancer, depression during treatment phase (1 year after diagnosis of prostate cancer) or in the follow-up phase was identified using the International Classification of Diseases-Ninth Revision depression-related codes...
October 2014: Urologic Oncology
https://www.readbyqxmd.com/read/25367402/the-initiative-to-maximize-progress-in-adolescent-and-young-adult-cancer-therapy-impact-cohort-study-a-population-based-cohort-of-young-canadians-with-cancer
#20
Nancy N Baxter, Corinne Daly, Sumit Gupta, Jason D Pole, Rinku Sutradhar, Mark L Greenberg, Paul C Nathan
BACKGROUND: Cancer is the leading cause of disease-related death in adolescents and young adults (AYA). Annual improvements in AYA cancer survival have been inferior to those observed in children and older adults. Prior studies of AYA with cancer have been limited by their focus on patients from select treatment centres, reducing generalizability, or by being population-based but lacking diagnostic and treatment details. There is a critical need to conduct population-based studies that capture detailed patient, disease, treatment and system-level data on all AYA regardless of treatment location...
2014: BMC Cancer
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