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https://www.readbyqxmd.com/read/28320079/ketamine-reduces-the-need-for-intubation-in-patients-with-acute-severe-mental-illness-and-agitation-requiring-transport-to-definitive-care-an-observational-study
#1
Cathrin S Parsch, Adrianne Boonstra, David Teubner, Wade Emmerton, Brian McKenny, Daniel Y Ellis
OBJECTIVES: The aim of this study was to review mental health patients transported by a dedicated statewide critical care retrieval team before and after the implementation of a ketamine sedation guideline. METHODS: This is a a retrospective cohort study of mental health patients with acute behavioural disturbance, transported between January 2010 and December 2015. RESULTS: A total of 78 patients were transported in the study period, 50 before and 28 after implementation of the ketamine guideline in June 2013...
March 20, 2017: Emergency Medicine Australasia: EMA
https://www.readbyqxmd.com/read/28320024/-therapeutic-decisions-concerning-severe-neurological-diseases-and-at-the-end-of-life
#2
Christoph Burkhard Lücking
Modern medicine increasingly enables survival of life-threatening diseases. On the other side, however, especially in Neurology, the questions have to be addressed how intensive the initial treatment should be and how to deal with residual states when severe functional or cognitive deficits are expected. In these cases, it is not only important to decide which medical measures are appropriate for the patient, but also whether, given the prognosis, the patient would agree with the suggested measures. This article first describes the basis for each medical action, i...
March 2017: Fortschritte der Neurologie-Psychiatrie
https://www.readbyqxmd.com/read/28319997/intradiscal-glucocorticoid-injection-for-patients-with-chronic-low-back-pain-associated-with-active-discopathy-a-randomized-trial
#3
Christelle Nguyen, Isabelle Boutron, Gabriel Baron, Katherine Sanchez, Clémence Palazzo, Raphaël Benchimol, Guillaume Paris, Étienne James-Belin, Marie-Martine Lefèvre-Colau, Johann Beaudreuil, Jean-Denis Laredo, Anne Béra-Louville, Anne Cotten, Jean-Luc Drapé, Antoine Feydy, Philippe Ravaud, François Rannou, Serge Poiraudeau
Background: Active discopathy is associated with a specific phenotype of chronic low back pain (LBP). Local inflammation has a role in active discopathy-associated symptoms. Objective: To assess the efficacy of a single glucocorticoid intradiscal injection (GC IDI) in patients with chronic LBP with active discopathy. Design: Prospective, parallel-group, double-blind, randomized, controlled study. (ClinicalTrials.gov: NCT00804531). Setting: 3 tertiary care centers in France...
March 21, 2017: Annals of Internal Medicine
https://www.readbyqxmd.com/read/28319692/development-and-properties-of-a-brief-scale-to-assess-intimate-partner-relationship-in-the-postnatal-period
#4
Karen Wynter, Thach Duc Tran, Heather Rowe, Jane Fisher
BACKGROUND: Poor quality intimate partner relationship is associated with postnatal depression and anxiety among women. Existing scales assessing the quality of this relationship are long and measure stable aspects of the relationship rather than specific behaviours which may respond to targeted interventions. The aim was to develop and investigate the properties of a brief, life stage-specific scale to assess potentially modifiable partner behaviours in the postpartum period. METHODS: Participants were primiparous women from diverse geographical and socio-economic backgrounds in Victoria, Australia...
March 14, 2017: Journal of Affective Disorders
https://www.readbyqxmd.com/read/28319653/the-ecology-of-human-microbiota-dynamics-and-diversity-in-health-and-disease
#5
Antti Karkman, Jenni Lehtimäki, Lasse Ruokolainen
Social welfare, better health care, and urbanization have greatly improved human health and well-being. On the other hand, Western societies suffer from the downsides of the elevated standard of living. Among other factors, the Western diet (poor in dietary fiber), lack of contact with natural biodiversity, and excessive antibiotic use are known to be associated with the increase in chronic inflammatory disorders. Limited exposure to microbial biodiversity, in combination with severe lifestyle-related disturbances to commensal microbial communities, especially during early life, is changing the diversity and composition of human microbiota...
March 20, 2017: Annals of the New York Academy of Sciences
https://www.readbyqxmd.com/read/28319589/exercise-improves-v-combining-dot-above-o-2max-and-body-composition-in-adt-treated-prostate-cancer-patients
#6
Bradley A Wall, Daniel A Galvão, Naeem Fatehee, Dennis R Taaffe, Nigel Spry, David Joseph, Jeffrey J Hebert, Robert U Newton
INTRODUCTION: Prostate cancer is the most common cancer in men and patients treated with androgen deprivation therapy (ADT) experience unfavourbale changes in body composition and associated metabolic complications, which can increase the risk of cardiovascular disease. We examined the effect of a 6-month program of aerobic and resistance exercise aimed at improving body composition and cardiorespiratory health in this population. METHODS: Ninety-seven men (43-90 years) with localized prostate cancer receiving ADT were randomized to either exercise (EX, n=50) or usual care (CON, n=47)...
March 18, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28319584/episode-of-care-characteristics-and-costs-for-hip-and-knee-replacement-surgery-in-hospitals-belonging-to-the-high-value-health-care-collaborative-compared-with-similar-hospitals-in-the-same-health-care-markets
#7
William B Weeks, William J Schoellkopf, David J Ballard, Gary S Kaplan, Brent James, James N Weinstein
BACKGROUND: To inform consumers and restrain health care cost growth, efforts to promote transparency and to reimburse for care episodes are accelerating in the United States. OBJECTIVE: To compare characteristics and costs of 30-day episode of care for hip and knee replacement occurring in High Value Healthcare Collaborative (HVHC)-member hospitals to those occurring in like non-HVHC-member hospitals in the same 15 health care markets before interventions by HVHC members to improve health care value for those interventions...
March 17, 2017: Medical Care
https://www.readbyqxmd.com/read/28319582/trends-in-the-purchase-of-surgical-care-in-the-community-by-the-veterans-health-administration-va
#8
Amy K Rosen, William O'Brien, Qi Chen, Michael Shwartz, Kamal F M Itani, William Gunnar
BACKGROUND: The 2014 implementation of the Veterans Choice Program increased opportunities for Veterans to receive care in the community. Although surgical care is a Veterans Health Administration (VA) priority, little is known about the types of surgeries provided in the VA versus those referred to community care (CC), and whether Veterans are increasing their use of surgical care through CC with these additional opportunities. OBJECTIVES: To examine national trends across VA facilities in the frequencies and types of surgeries provided in the VA and through CC, and explore the association between facilities' purchase of care with rurality and surgical complexity designation...
March 17, 2017: Medical Care
https://www.readbyqxmd.com/read/28319472/infective-endocarditis-in-children-an-update
#9
Garth Dixon, Georgi Christov
PURPOSE OF REVIEW: Infective endocarditis in children remains a clinical challenge. Here, we review the impact of the updated 2015 American Heart Association and European Society of Cardiology guidelines on management as well as the significance of the new predisposing factors, diagnostic and treatment options, and the impact of the 2007-2008 change in prophylaxis recommendations. RECENT FINDINGS: The new 2015 infective endocarditis guidelines introduced the endocarditis team, added the new imaging modalities of computer tomography and PET-computer tomography into the diagnostic criteria and endorsed the concept of safety of relatively early surgical treatment...
March 17, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28319319/association-between-religious-practice-and-risk-of-depression-in-older-people-in-the-subacute-setting
#10
Alice Lac, Nicole Austin, Renata Lemke, Suma Poojary, Peter Hunter
OBJECTIVE: To identify the association between religious practice and risk of depression in older people admitted to a subacute hospital. METHODS: A cross-sectional survey was conducted with 100 patients aged ≥65 years with Mini-Mental State Examination (MMSE) scores ≥24 consecutively admitted to a subacute hospital. Religious practice was measured using the Duke University Religion Index and risk of depression using the 15-item Geriatric Depression Scale (GDS)...
March 20, 2017: Australasian Journal on Ageing
https://www.readbyqxmd.com/read/28319308/concepts-models-and-measurement-of-continuity-of-care-in-mental-health-services-a-systematic-appraisal-of-the-literature
#11
REVIEW
Nick Weaver, Michael Coffey, Jeanette Hewitt
INTRODUCTION: The increased complexity of community mental health services, and associated fragmentation of traditional dividing lines between services, has underscored the centrality of care continuity and coordination in modern mental healthcare. However, clarification of the key features of the care continuity concept has proved difficult and a consensus has not been reached. AIM/QUESTION: This review draws together and critically examines latest evidence concerning concepts, models and scales based on a multi-dimensional understanding of care continuity...
March 20, 2017: Journal of Psychiatric and Mental Health Nursing
https://www.readbyqxmd.com/read/28319242/quality-of-cancer-surveillance-clinical-practice-guidelines-specificity-and-consistency-of-recommendations
#12
Ryan P Merkow, Deborah Korenstein, Rubaya Yeahia, Peter B Bach, Shrujal S Baxi
Importance: Primary care clinicians, who are increasingly responsible for caring for the growing population of cancer survivors, may be unfamiliar with appropriate cancer surveillance strategies. Clinical practice guidelines can inform cancer follow-up care and surveillance testing. Vague recommendations and inconsistencies among guidelines can lead to overuse and underuse of health care resources and have a negative impact on cost and quality of survivorship care. Objective: To examine the specificity and consistency of recommendations for surveillance after active treatment across cancer guidelines...
March 20, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28319231/association-of-suicidality-and-depression-with-5%C3%AE-reductase-inhibitors
#13
Blayne Welk, Eric McArthur, Michael Ordon, Kelly K Anderson, Jade Hayward, Stephanie Dixon
Importance: There have been concerns raised by patients and regulatory agencies regarding serious psychiatric adverse effects associated with 5α-reductase inhibitors. Objective: To determine if there is an increased risk of suicide, self-harm, or depression among older men starting a 5α-reductase inhibitor for prostatic enlargement. Design, Setting, and Participants: A population-based, retrospective, matched cohort study using linked administrative data for 93 197 men ages 66 years or older (median [IQR] age, 75 [70-80] years) in Ontario, Canada, who initiated a new prescription for a 5α-reductase inhibitor during the study period (2003 through 2013)...
March 20, 2017: JAMA Internal Medicine
https://www.readbyqxmd.com/read/28318952/glycaemic-variability-in-patients-with-severe-sepsis-or-septic-shock-admitted-to-an-intensive-care-unit
#14
L M Silveira, A Basile-Filho, E A Nicolini, C A M Dessotte, G C S Aguiar, A M Stabile
BACKGROUND: Sepsis is associated with morbidity and mortality, which implies high costs to the global health system. Metabolic alterations that increase glycaemia and glycaemic variability occur during sepsis. OBJECTIVE: To verify mean body glucose levels and glycaemic variability in Intensive Care Unit (ICU) patients with severe sepsis or septic shock. METHOD: Retrospective and exploratory study that involved collection of patients' sociodemographic and clinical data and calculation of severity scores...
March 15, 2017: Intensive & Critical Care Nursing: the Official Journal of the British Association of Critical Care Nurses
https://www.readbyqxmd.com/read/28318632/endovascular-aneurysm-repair-evar-and-transcatheter-aortic-valve-replacement-tavr-associated-acute-kidney-injury
#15
REVIEW
Kenar D Jhaveri, Athanasios N Saratzis, Rimda J Wanchoo, Pantelis A Sarafidis
Acute kidney injury (AKI) after surgery or intervention is an important complication that may impact mortality, morbidity, and health care costs. Endovascular procedures are now performed routinely for a variety of pathologies that were traditionally treated with open surgery because randomized trials comparing endovascular and open surgery have shown at least equally good results and reduced complication and hospitalization rates with endovascular techniques. However, endovascular procedures have been associated with an increased risk for postoperative AKI, predominantly owing to contrast nephrotoxicity...
March 16, 2017: Kidney International
https://www.readbyqxmd.com/read/28318602/metals-hormones-and-sexual-maturation-in-flemish-adolescents-in-three-cross-sectional-studies-2002-2015
#16
Sam De Craemer, Kim Croes, Nicolas van Larebeke, Stefaan De Henauw, Greet Schoeters, Eva Govarts, Ilse Loots, Tim Nawrot, Vera Nelen, Elly Den Hond, Liesbeth Bruckers, Yue Gao, Willy Baeyens
Sex hormone levels and timing of sexual maturation are considered important markers for health status of adolescents in puberty, and previous research suggests they might be influenced by metal exposure. In three campaigns of the Flemish Environment and Health Study (FLEHS I 2002-2006; FLEHS II 2007-2011 and FLEHS III 2012-2015), data were collected on internal exposure to metals (Cd, Cu, Pb, Cr, Mn, Tl, Ni, Sb, Hg, As and As species) and sexual maturation in 2671 14-15years old adolescents. All metals were measured in blood and/or urine, except total- and methylmercury which were measured in hair samples...
March 17, 2017: Environment International
https://www.readbyqxmd.com/read/28318349/visual-morbidity-and-ocular-complications-in-presumed-intraocular-tuberculosis-an-analysis-of-354-cases-from-a-non-endemic-population
#17
Dinesh Visva Gunasekeran, Bhaskar Gupta, Joao Cardoso, Carlos E Pavesio, Rupesh Agrawal
PURPOSE: To describe the visual morbidity associated with intraocular tuberculosis (TB) and to report ocular complications of intraocular TB. METHODS: Retrospective cohort study of patients diagnosed with intraocular TB at a tertiary referral eye care hospital in central London. Data on baseline and final best-corrected visual acuity (BCVA) along with ocular complications were collected and analyzed. RESULTS: In total, 354 patients with intraocular TB were included in this study...
March 20, 2017: Ocular Immunology and Inflammation
https://www.readbyqxmd.com/read/28318179/depressive-symptoms-and-associated-factors-in-caregivers-of-newborn-infants-hospitalized-in-a-neonatal-intensive-care-unit
#18
Jorge L Alvarado Socarrás, Edna M Gamboa-Delgado, Silvia Trujillo Cáceres, Sandra Rodríguez Forero
INTRODUCTION: A high prevalence of depressive symptoms has been reported in family members of newborn infants hospitalized in neonatal intensive care units. This causes a high negative impact on the newborn infant-family bond. OBJECTIVE: To establish the prevalence of depressive symptoms and their associated factors in caregivers of newborn infants hospitalized in a neonatal intensive care unit in Colombia. MATERIALS AND METHODS: Cross-sectional, analytical study conducted at a tertiary care health facility specialized in cardiovascular disease...
April 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28317575/infection-control-in-the-dental-office
#19
REVIEW
Francesco R Sebastiani, Harry Dym, Tarun Kirpalani
The goal of an infection control program is to provide a safe working environment for dental health care personnel and their patients. Practitioners can achieve this by adopting measures that reduce health care-associated infections among patients and occupational exposures among dental health care personnel. It is crucial for all dental practitioners to be up to date on current Centers for Disease Control and Prevention guidelines, equipment, and techniques for proper infection control. Continuous evaluation of infection control practices is important...
April 2017: Dental Clinics of North America
https://www.readbyqxmd.com/read/28317571/recent-recommendations-for-management-of-human-immunodeficiency-virus-positive-patients
#20
REVIEW
Miriam R Robbins
Human immunodeficiency virus (HIV) infection has become a chronic condition. HIV is not a valid reason to deny, delay, or withhold dental treatment. There are no absolute contraindications and few complications associated with comprehensive oral health care treatment delivered in an outpatient setting for asymptomatic HIV-infected patients and clinically stable patients with AIDS. Consultation with the patient's medical provider and modifications in the delivery of dental treatment may be necessary when treating patients with advanced HIV disease or other comorbid conditions...
April 2017: Dental Clinics of North America
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