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Transitions in the hospital

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https://www.readbyqxmd.com/read/28087113/video-assisted-thoracoscopic-diaphragm-plication-using-a-running-suture-technique-is-durable-and-effective
#1
David S Demos, Mark F Berry, Leah M Backhus, Joseph B Shrager
OBJECTIVE: Surgeons have hesitated to adopt minimally invasive diaphragm plication techniques because of technical limitations rendering the procedure cumbersome or leading to early failure or reduced efficacy. We sought to demonstrate efficacy and durability of our thoracoscopic plication technique using a single running suture. METHODS: We retrospectively reviewed patients who underwent our technique for diaphragm plication since 2008. We used a single, buttressed, double-layered, to-and-fro running suture with additional plicating horizontal mattress sutures as needed...
December 21, 2016: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/28086902/exploiting-temporal-and-nonstationary-features-in-breathing-sound-analysis-for-multiple-obstructive-sleep-apnea-severity-classification
#2
Jaepil Kim, Taehoon Kim, Donmoon Lee, Jeong-Whun Kim, Kyogu Lee
BACKGROUND: Polysomnography (PSG) is the gold standard test for obstructive sleep apnea (OSA), but it incurs high costs, requires inconvenient measurements, and is limited by a one-night test. Thus, a repetitive OSA screening test using affordable data would be effective both for patients interested in their own OSA risk and in-hospital PSG. The purpose of this research was to develop a four-OSA severity classification model using a patient's breathing sounds. METHODS: Breathing sounds were recorded from 83 subjects during a PSG test...
January 7, 2017: Biomedical Engineering Online
https://www.readbyqxmd.com/read/28079726/the-charter-on-professionalism-for-health-care-organizations
#3
Barry E Egener, Diana J Mason, Walter J McDonald, Sally Okun, Meg E Gaines, David A Fleming, Bernie M Rosof, David Gullen, May-Lynn Andresen
In 2002, the Physician Charter on Medical Professionalism was published to provide physicians with guidance for decision making in a rapidly changing environment. Feedback from physicians indicated that they were unable to fully live up to the principles in the 2002 charter partly because of their employing or affiliated health care organizations. A multistakeholder group has developed a Charter on Professionalism for Health Care Organizations, which may provide more guidance than charters for individual disciplines, given the current structure of health care delivery systems...
January 10, 2017: Academic Medicine: Journal of the Association of American Medical Colleges
https://www.readbyqxmd.com/read/28079640/comparison-of-the-american-joint-committee-on-cancer-seventh-edition-and-brigham-and-women-s-hospital-cutaneous-squamous-cell-carcinoma-tumor-staging-in-immunosuppressed-patients
#4
Jessica L Gonzalez, Kiera Cunningham, Rebecca Silverman, Elena Madan, Bichchau M Nguyen
BACKGROUND: The American Joint Committee on Cancer 7th edition (AJCC-7) and Brigham and Women's Hospital (BWH) staging criteria for cutaneous squamous cell carcinoma (cSCC) have not been validated in immunosuppressed patients. OBJECTIVE: To compare the AJCC-7 and BWH staging systems for cSCCs in immunosuppressed patients. METHODS AND MATERIALS: A single-institution retrospective cohort study of cSCCs in immunosuppressed patients. Risks of local recurrence (LR), nodal metastasis (NM), in-transit metastasis, and any poor outcome (PO) were compared among AJCC-7 and BWH tumor T stages...
January 10, 2017: Dermatologic Surgery: Official Publication for American Society for Dermatologic Surgery [et Al.]
https://www.readbyqxmd.com/read/28078479/follow-up-cancer-care-perspectives-of-aboriginal-and-torres-strait-islander-cancer-survivors
#5
J A Meiklejohn, G Garvey, R Bailie, E Walpole, J Adams, D Williamson, J Martin, C M Bernardes, B Arley, B Marcusson, P C Valery
PURPOSE: The purpose of this study was to explore Indigenous Australian cancer survivors' perspectives of follow-up cancer care and management.. METHODS: This is a qualitative study employing individual interviews with 21 Indigenous cancer survivors (13 females, 8 males) recruited from a rural primary health service and large tertiary hospital in Brisbane, Queensland. Yarning methods were used to conduct semi-structured interviews. Yarning is a culturally appropriate, informal conversational process emphasising the importance of storytelling...
January 12, 2017: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/28075698/older-adults-and-management-of-medical-devices-in-the-home-five-requirements-for-appropriate-use
#6
Sara C Keller, Ayse P Gurses, Nicole Werner, Dawn Hohl, Ashley Hughes, Bruce Leff, Alicia I Arbaje
Medical devices, or instruments or tools to manage disease, are increasingly used in the home, yet there have been limited evaluations of how older adults and caregivers safely use these devices. This study concerns a qualitative evaluation of (1) barriers and facilitators of appropriate use, and (2) outcomes of inappropriate use, among older adults at the transition from hospital to home with skilled home health care (SHHC). Guided by a human factors engineering work system model, the authors (1) conducted direct observations with contextual inquiry of the start-of-care or resumption-of-care SHHC provider visit, and (2) semi-structured interviews with 24 older adults and their informal caregivers, and 39 SHHC providers and administrators...
January 11, 2017: Population Health Management
https://www.readbyqxmd.com/read/28074757/advanced-practice-nurse-transitional-care-model-promotes-healing-in-wound-care
#7
Carole Mackavey
: Optimally, transition in health care should be seamless and incorporate a well-thought-out patient-centered discharge plan; yet, many hospitalized patients are unprepared for discharge, thereby compromising patient safety and quality of care. Transition of care should include a broad range of time-limited services designed to ensure health care continuity to avoid poor outcomes among at-risk populations. This case study demonstrates that advanced practice nurses (APNs) are in the perfect position to bridge the existing gap, reduce readmissions, and improve patient health...
September 1, 2016: Care Management Journals: Journal of Case Management ; the Journal of Long Term Home Health Care
https://www.readbyqxmd.com/read/28072956/-clinical-and-immunological-analysis-of-the-patient-with-autoimmunity-due-to-germline-stat3-gain-of-function-mutation
#8
Y Ding, Y Zhang, Y P Wang, H Y Zhao, X M Chen, X H Xue, X M Bai, Y F An, Z Y Zhang, X M Tang, X D Zhao
Objective: To investigate the clinical and immunological laboratory features and gene mutation in a female patient who carried a germline gain-of-function mutation in STAT3. Method: A patient with lymphadenopathy and pancytopenia, visited the Department of Rheumatology and Immunology of Children's Hospital of Chongqing Medical University in May 2016. The clinical and laboratory characteristics, results of immunophenotyping and exome sequencing were analyzed retrospectively and related literature was reviewed...
January 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28072954/-clinical-and-immunological-analysis-of-patients-with-activated-phosphoinositide-3-kinase-%C3%AE-syndrome-resulting-from-pik3cd-mutation
#9
W J Tang, W Wang, Y Luo, Y P Wang, L Li, Y F An, L J Gou, M S Ma, T Y He, J Yang, X D Zhao, H M Song
Objective: To explore the clinical and immunological features, gene mutations, treatment and prognosis in patients with activated phosphoinositide 3-kinase δ syndrome (APDS) caused by PIK3CD gene heterozygous germline mutation. Method: The data of clinical, immunological phenotype, treatment, and prognosis of 15 patients with APDS, who visited Children's Hospital of Chongqing Medical University, Peking Union Medical College Hospital, and Shenzhen Children's Hospital from June 2014 to November 2016, were collected and analyzed...
January 2, 2017: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/28069680/medication-errors-associated-with-transition-from-insulin-pens-to-insulin-vials
#10
Adam N Trimble, Bryan Bishop, Nancy Rampe
PURPOSE: Three insulin administration errors that occurred after a hospital's transition from insulin pens to vials are described, and process improvement initiatives implemented to prevent future errors are reviewed. SUMMARY: In response to numerous reports and warnings related to the risk of insulin pen sharing, a 450-bed community hospital made a transition from insulin pens to insulin vials. Shortly after this transition, three major medication errors involving insulin occurred...
January 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/28069285/dialysis-modality-and-readmission-following-hospital-discharge-a-population-based-cohort-study
#11
Jeffrey Perl, Eric McArthur, Chaim Bell, Amit X Garg, Joanne M Bargman, Christopher T Chan, Shai Harel, Lihua Li, Arsh K Jain, Danielle M Nash, Ziv Harel
BACKGROUND: Readmissions following hospital discharge among maintenance dialysis patients are common, potentially modifiable, and costly. Compared with patients receiving in-center hemodialysis (HD), patients receiving peritoneal dialysis (PD) have fewer routine dialysis clinic encounters and as a result may be more susceptible to a hospital readmission following discharge. STUDY DESIGN: Population-based retrospective-cohort observational study. SETTINGS & PARTICIPANTS: Patients treated with maintenance dialysis who were discharged following an acute-care hospitalization during January 1, 2003, to December 31, 2013, across 164 acute-care hospitals in Ontario, Canada...
January 6, 2017: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28069153/working-in-silos-head-neck-cancer-patients-during-and-after-treatment-with-or-without-early-palliative-care-referral
#12
Helena Ullgren, Lily Kirkpatrick, Sini Kilpeläinen, Lena Sharp
PURPOSE: The primary aim was to describe patients with Head and Neck (H&N) cancer referred to palliative care and how the care transition from acute oncological to palliative care impacted on both Health related quality of life (HRQoL) and information. The secondary aim was to explore H&N cancer patients' HRQoL and perceived information. METHODS: H&N cancer patients were identified via the Swedish Cancer Register. Data were collected using the following questionnaires; European Organization for Research and Treatment of Cancer (EORTC) QLQ C-30, INFO25, and a study-specific questionnaire...
February 2017: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
https://www.readbyqxmd.com/read/28067857/impact-of-a-transition-from-respiratory-virus-shell-vial-to-multiplex-pcr-on-clinical-outcomes-and-cost-in-hospitalized-children
#13
Pui-Ying Iroh Tam, Lei Zhang, Zohara Cohen
While respiratory virus PCR panel (RVPP) is more expensive than shell vial (SV) cell culture, it has been shown to reduce unnecessary diagnostic procedures, decrease the inappropriate use of antimicrobials, and shorten the hospital length of stay (LOS). We therefore hypothesized that, for hospitalized children, RVPP would be associated with improved clinical outcomes but higher hospital charges than SV cell culture. We performed a retrospective cohort study of hospitalized children. Multivariate analysis was performed, and p-values were calculated...
January 7, 2017: Children
https://www.readbyqxmd.com/read/28065960/urinary-bladder-cancer-in-adults-a-histopathological-experience-from-madinah-saudi-arabia
#14
Abeer Abdalla El-Siddig, Abdulkader Mohammed Albasri, Akbar Shah Hussainy, Ahmed Safar Alhujaily
OBJECTIVE: To delineate the frequency and clinicopathological features of urinary bladder cancer. METHODS: This retrospective study was conducted at the King Fahd Hospital, Madinah, Saudi Arabia, and comprised medical records related to bladder tumours, from January 2006 to October 2015. Data was obtained from histopathologic reports and evaluated for age, gender, cystoscopic findings and histopathological characteristics at the time of presentation. RESULTS: Of the 116 cases, 96(82...
January 2017: JPMA. the Journal of the Pakistan Medical Association
https://www.readbyqxmd.com/read/28065689/virtual-teach-to-goal%C3%A2-adaptive-learning-of-inhaler-technique-for-inpatients-with-asthma-or-copd
#15
Valerie G Press, Colleen A Kelly, John J Kim, Steven R White, David O Meltzer, Vineet M Arora
BACKGROUND: Asthma and chronic obstructive pulmonary disease (COPD) result in more than 1 million hospitalizations annually. Most hospitalized patients misuse respiratory inhalers. This misuse can be corrected with in-person education; however, this strategy is resource intensive and skills wane quickly after discharge. OBJECTIVE: The objective of this study was to develop and pilot a virtual teach-to-goal™ (V-TTG™) inhaler skill training module, using innovative adaptive learning technology...
January 5, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28065611/-diet-and-lifestyle-rules-in-chronic-constipation-in-adults-from-fantasy-to-reality%C3%A2
#16
Nadia Fathallah, Dominique Bouchard, Vincent de Parades
Chronic constipation is one of the most common chronic gastrointestinal complaints and a frequent reason for consultation. Lifestyle modification and dietary advice attract a lot of patients, often dissatisfied with a long-term drug intake. These behavioral modifications are recommended as a first-line approach in the treatment of chronic mild constipation in the majority of current guidelines despite a low level of evidence. Fiber supplementation is probably the most relevant measure because of a satisfactory level of proof...
January 5, 2017: La Presse Médicale
https://www.readbyqxmd.com/read/28062678/facility-practice-variation-to-help-understand-the-effects-of-public-policy-insights-from-the-dialysis-outcomes-and-practice-patterns-study-dopps
#17
Douglas S Fuller, Bruce M Robinson
Recent Centers for Medicare & Medicaid Services policies have used dialysis facility practice variation to develop public ratings and adjust payments. In the Dialysis Facility Compare star rating system (DFC SRS), facility-relative rates of performance-based clinical measures varied nearly two-fold for mortality (standardized mortality ratio; 10th/90th percentiles: 0.71, 1.34) and hospitalization (standardized hospitalization ratio; 10th/90th percentiles: 0.64, 1.37), and nearly four-fold for transfusion (standardized transfusion ratio; 10th/90th percentiles: 0...
January 6, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/28057950/reduction-of-30-day-hospital-readmissions-after-patient-centric-telephonic-medication-therapy-management-services
#18
Daryl E Miller, Teresa E Roane, Karen D McLin
Background: Transitional care programs are a growing topic in health care systems across the country, with a focus on achieving a reduction in hospital readmissions and improving patient and medication safety. Numerous strategies have been employed and studied to determine successful approaches to patient transition from the hospital setting to the home setting. Pharmacist-mediated postdischarge telephonic outreach has demonstrated decreased hospital readmission rates in multiple hospital systems. Objective: To evaluate the effectiveness of pharmacist-facilitated telephonic medication therapy management (MTM) services on reducing hospital readmissions...
December 2016: Hospital Pharmacy
https://www.readbyqxmd.com/read/28057371/3-meo-pcp-intoxication-in-two-young-men-first-in-vivo-detection-in-italy
#19
Elisabetta Bertol, Jennifer Pascali, Diego Palumbo, Valeria Catalani, Maria Grazia Di Milia, Alessia Fioravanti, Francesco Mari, Fabio Vaiano
3-MeO-PCP or 3-methoxyphencyclidine is a derivative of phencyclidine. It acts as a dissociative anesthetic and it has allegedly hallucinogenic and sedative effects. There are almost no documented intoxication cases and references about its pharmacology and toxicity in literature. This study presents two concomitant intoxication cases due to consumption of 3-MeO-PCP and alcohol. A 19 (A) and a 21 years old (B) men were brought to Santa Maria Nuova Hospital in a comatose state (Glasgow score 3). They showed respiratory acidosis, right anisocoria with mydriatic pupils and hypothermia...
December 26, 2016: Forensic Science International
https://www.readbyqxmd.com/read/28056276/-infection-status-clinical-symptoms-and-gene-type-transition-of-group-a-rotavirus-in-children-less-than-five-years-of-age-with-diarrhea-in-sentinel-hospitals-of-henan-province-china
#20
J Y Zhao, X J Shen, S L Xia, B F Zhang, Y J Mu, X Y Huang, B L Xu
Objective: To investigate the infectious status, gene type transition and epidemiological features of rotavirus A isolated from infants and children (<59 months-of-age) in sentinel hospitals from 2008 to 2015 in Henan province, China. Methods: In total, 2 541 stool samples (each 3- 5 ml) were collected from infants and children aged less than five years in two sentinel hospitals and group A rotavirus was detected by a double antibody sandwich ELISA. Viral RNA was extracted from positive samples and G/P gene typing was performed using a two-step nested multiplex RT-PCR...
January 6, 2017: Zhonghua Yu Fang Yi Xue za Zhi [Chinese Journal of Preventive Medicine]
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