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https://www.readbyqxmd.com/read/29150897/determining-best-outcomes-from-community-acquired-pneumonia-and-how-to-achieve-them
#1
REVIEW
Jane Hadfield, Lesley Bennett
Community-acquired pneumonia (CAP) is a common acute medical illness with a standard, effective treatment that was introduced before the evidenced-based medicine era. Mortality rates have improved in recent decades but improvements have been minimal when compared to other conditions such as acute coronary syndromes. The standardized approach to treatment makes CAP a target for comparative performance and outcome measures. While easy to collect, simplistic outcomes such as mortality, readmission and length of stay are difficult to interpret as they can be affected by subjective choices and health care resources...
November 17, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/29143487/nurses-implementation-of-ventilator-associated-pneumonia-prevention-guidelines-an-observational-study-in-jordan
#2
Sami M Aloush
BACKGROUND: Ventilator-associated pneumonia prevention guidelines from the Center for Disease Control and Prevention, the American Thoracic Society, and the Institute for Health Care and Improvement have been published to reduce the rate of ventilator-associated pneumonia in the clinical settings; however, nurses' compliance with these guidelines is still questionable. AIMS: The purpose of this study was to assess nurses' compliance with ventilator-associated pneumonia prevention guidelines and the factors that influence their compliance...
November 15, 2017: Nursing in Critical Care
https://www.readbyqxmd.com/read/29138486/the-impact-of-a-specialized-spinal-cord-injury-center-as-compared-with-non-specialized-centers-on-the-acute-respiratory-management-of-patients-with-complete-tetraplegia-an-observational-study
#3
Andréane Richard-Denis, Debbie Feldman, Cynthia Thompson, Martin Albert, Jean-Marc Mac-Thiong
STUDY DESIGN: Retrospective cohort study. OBJECTIVES: To compare the proportion of tracheostomy placement and duration of mechanical ventilation (MV) in patients with a complete cervical spinal cord injury (SCI) that were managed early or lately in a specialized acute SCI-center. The second objective was to determine the impact of the timing of admission to the SCI-center on the MV support duration. SETTING: A single Level-1 trauma center specialized in SCI care in Quebec (Canada)...
November 15, 2017: Spinal Cord
https://www.readbyqxmd.com/read/29129186/an-exploration-of-mortality-risk-factors-in-non-severe-pneumonia-in-children-using-clinical-data-from-kenya
#4
Timothy Tuti, Ambrose Agweyu, Paul Mwaniki, Niels Peek, Mike English
BACKGROUND: Childhood pneumonia is the leading infectious cause of mortality in children younger than 5 years old. Recent updates to World Health Organization pneumonia guidelines recommend outpatient care for a population of children previously classified as high risk. This revision has been challenged by policymakers in Africa, where mortality related to pneumonia is higher than in other regions and often complicated by comorbidities. This study aimed to identify factors that best discriminate inpatient mortality risk in non-severe pneumonia and explore whether these factors offer any added benefit over the current criteria used to identify children with pneumonia requiring inpatient care...
November 13, 2017: BMC Medicine
https://www.readbyqxmd.com/read/29120096/the-association-between-oral-health-status-and-respiratory-pathogen-colonization-with-pneumonia-risk-in-institutionalized-adults
#5
Chl Hong, M M Aung, K Kanagasabai, C A Lim, S Liang, K S Tan
OBJECTIVES: This study aimed to assess the oral health and the prevalence of pre-existing oral colonization with respiratory pathogens in dependent elderly, and whether these factors influence pneumonia development. MATERIALS AND METHODS: Participants residing in a long-term care facility received bedside oral examinations, and information on their oral health (caries status, calculus index and debris index) was obtained. Samples from the tongue and teeth were collected at baseline and at time of pneumonia development...
November 9, 2017: International Journal of Dental Hygiene
https://www.readbyqxmd.com/read/29118045/measurement-of-selected-preventable-adverse-drug-events-in-electronic-health-records-toward-developing-a-complexity-score
#6
Nakyung Jeon, Magarita Sorokina, Carl Henriksen, Ben Staley, Gloria Pflugfelder Lipori, Almut G Winterstein
PURPOSE: The defining of a select number of high-priority preventable adverse drug events (pADEs) for measurement in the electronic health record (EHR) and the estimation of pADE incidences in two tertiary care facilities are described. METHODS: This study was part of a larger effort aimed at developing an automated electronic health record (EHR)-based complexity-score (C-score) that ranks hospitalized patients according to their risk for pADEs for clinical intervention...
November 15, 2017: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/29097339/comparable-outcomes-among-trial-and-non-trial-participants-in-a-clinical-trial-of-antibiotics-for-childhood-pneumonia-a-retrospective-cohort-study
#7
Ambrose Agweyu, Jacquie Oliwa, David Gathara, Naomi Muinga, Elizabeth Allen, Richard J Lilford, Mike English
OBJECTIVE: We compared characteristics and outcomes of children enrolled in a randomized controlled trial (RCT) comparing oral amoxicillin and benzyl penicillin for the treatment of chest indrawing pneumonia versus children who received routine care to determine the external validity of the trial results. STUDY DESIGN AND SETTING: We undertook a retrospective cohort study of children aged 2 - 59 months admitted in six Kenyan hospitals. Data for non-trial participants were extracted from inpatient records upon conclusion of the RCT...
October 30, 2017: Journal of Clinical Epidemiology
https://www.readbyqxmd.com/read/29081000/association-between-medicare-s-mandatory-hospital-value-based-purchasing-program-and-cost-inefficiency
#8
Germán M Izón, Chelsea A Pardini
BACKGROUND: The Patient Protection and Affordable Care Act instituted pay-for-performance programs, including Hospital Value-Based Purchasing (HVBP), designed to encourage hospital quality and efficiency. OBJECTIVE AND METHOD: While these programs have been evaluated with respect to their implications for care quality and financial viability, this is the first study to assess the relationship between hospitals' cost inefficiency and their participation in the programs...
October 28, 2017: Applied Health Economics and Health Policy
https://www.readbyqxmd.com/read/29078905/sphingosine-rescues-aged-mice-from-pulmonary-pseudomonas-infection
#9
Teresa C Rice, Amanda M Pugh, Aaron P Seitz, Erich Gulbins, Vanessa Nomellini, Charles C Caldwell
BACKGROUND: Bacterial lung infection is a leading cause of death for those 65 y or older, often requiring intensive care unit admission and mechanical ventilation, which consumes considerable health care resources. Although administration of antibiotics is the standard of care for bacterial pneumonia, its overuse has led to the emergence of multidrug resistant organisms. Therefore, alternative strategies to help minimize the effects of bacterial pneumonia in the elderly are necessary...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29078880/impact-of-complications-on-length-of-stay-in-elective-laparoscopic-colectomies
#10
Mary Megan Mrdutt, Claire L Isbell, J Scott Thomas, Courtney N Shaver, Rahila Essani, Rajalakshmi Warrier, Harry Troy Papaconstantinou
BACKGROUND: Length of hospital stay (LOS) is an indirect measure of surgical quality and a surrogate for cost. The impact of postoperative complications on LOS following elective colorectal surgery is not well defined. The purpose of this study is to determine the contribution of specific complications towards LOS in elective laparoscopic colectomy patients. MATERIALS AND METHODS: American College of Surgeon's National Surgical Quality Improvement Program database (2011-2014) was queried for patients undergoing elective laparoscopic partial colectomy with primary anastomosis...
November 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/29078810/improving-oxygen-therapy-for-children-and-neonates-in-secondary-hospitals-in-nigeria-study-protocol-for-a-stepped-wedge-cluster-randomised-trial
#11
Hamish R Graham, Adejumoke I Ayede, Ayobami A Bakare, Oladapo B Oyewole, David Peel, Amy Gray, Barbara McPake, Eleanor Neal, Shamim Qazi, Rasa Izadnegahdar, Adegoke G Falade, Trevor Duke
BACKGROUND: Oxygen is a life-saving, essential medicine that is important for the treatment of many common childhood conditions. Improved oxygen systems can reduce childhood pneumonia mortality substantially. However, providing oxygen to children is challenging, especially in small hospitals with weak infrastructure and low human resource capacity. METHODS/DESIGN: This trial will evaluate the implementation of improved oxygen systems at secondary-level hospitals in southwest Nigeria...
October 27, 2017: Trials
https://www.readbyqxmd.com/read/29077289/-predictors-of-drug-resistant-pathogens-in-community-onset-pneumonia-are-factors-considered-in-health-care-associated-pneumonia-useful-in-the-emergency-department
#12
Olga H Torres Bonafonte, Eva Gil Olivas, Estefanía Pérez Macho, Cristina Pacho Pacho, Miriam Mateo Roca, Jordi Casademont Pou, Domingo Ruiz Hidalgo
OBJECTIVES: To analyze factors related to drug-resistant pathogens (DRPs) in community-onset pneumonia (COP) and whether previously suggested criteria are useful in our emergency-department. MATERIAL AND METHODS: Prospective 1-year study of adults coming to the emergency department for COP. We assessed the usefulness of criteria used in health-care-associated pneumonia (HCAP), as well the Shorr index, the Barthel index, and clinical suspicion of resistant pathogens...
October 2017: Emergencias
https://www.readbyqxmd.com/read/29071221/evaluating-adherence-of-health-care-team-to-standard-guideline-of-colistin-use-at-intensive-care-units-of-a-referral-hospital-in-shiraz-southwest-of-iran
#13
Afsaneh Vazin, Iman Karimzadeh, Atiyeh Zand, Nazafarin Hatami-Mazinani, Dena Firouzabadi
Purpose: To evaluate colistin use according to global standard drug consumption in intensive care units of a referral hospital in Shiraz, Iran Methods: A prospective, interventional study was performed during an 11 month period on 100 patients admitted to ICUs of a teaching hospital being treated with colistin for at least 3 subsequent doses. Required demographic, clinical, and paraclinical data were gathered by a pharmacist. Fifteen indexes were considered to evaluate colistin use. A clinical pharmacist reviewed indication and dose of colistin at the time of prescribing this agent...
September 2017: Advanced Pharmaceutical Bulletin
https://www.readbyqxmd.com/read/29066584/predicting-30-day-all-cause-readmission-risk-for-subjects-admitted-with-pneumonia-at-the-point-of-care
#14
Umur Hatipoğlu, Brian J Wells, Kevin Chagin, Dhruv Joshi, Alex Milinovich, Michael B Rothberg
BACKGROUND: The pneumonia 30-d readmission rate has been endorsed by the National Quality Forum as a quality metric. Hospital readmissions can potentially be lowered by improving in-hospital care, transitions of care, and post-discharge disease management programs. The purpose of this study was to create an accurate prediction model for determining the risk of 30-d readmission at the point of discharge. METHODS: The model was created using a data set of 1,295 hospitalizations at the Cleveland Clinic Main Campus with pneumonia over 3 y...
October 24, 2017: Respiratory Care
https://www.readbyqxmd.com/read/29066003/clinical-outcomes-after-burns-in-elderly-patients-over-70-years-a-17-year-retrospective-analysis
#15
Gregg Dexter, Sachin Patil, Kanwardeep Singh, Michael A Marano, Robin Lee, Sylvia J Petrone, Ronald S Chamberlain
INTRODUCTION: In the United Stated population >70years is likely to double by the year 2050. Elderly population (>70years) are most vulnerable to burns and outcomes following such injuries in this special group is poorly studied. This study aimed to look at outcomes following burns in patients >70years over a period of 17 years. MATERIALS AND METHODS: Data on 6512 patients admitted to a Level I Burn Center between 1995 and 2011 was analyzed. Age, gender, ethnicity, TBSA, burn etiology, hospital and burn intensive care unit (ICU) length of stay (LOS) and status at discharge were abstracted...
October 20, 2017: Burns: Journal of the International Society for Burn Injuries
https://www.readbyqxmd.com/read/29064347/excess-mortality-in-italy-should-we-care-about-low-influenza-vaccine-uptake
#16
Francia Fausto, Pandolfi Paolo, Odone Anna, Signorelli Carlo
AIMS: The aims of this study were to explore 2015 mortality data further and to assess excess deaths' determinants. METHODS: We analysed data from a large metropolitan area in the north of Italy, the city of Bologna. We took advantage of a comprehensive local-level database and merged three different data sources to analitically explore reported 2014-2015 excess mortality and its determinants. Effect estimates were derived from multivariable Poisson regression analysis, according to vaccination status and frailty index...
October 1, 2017: Scandinavian Journal of Public Health
https://www.readbyqxmd.com/read/29063446/extensive-colonization-with-carbapenemase-producing-microorganisms-in-romanian-burn-patients-infectious-consequences-from-the-colectiv-fire-disaster
#17
L E Pirii, A W Friedrich, J W A Rossen, W Vogels, G I J M Beerthuizen, M K Nieuwenhuis, A M D Kooistra-Smid, E Bathoorn
Health care of severe burn patients is highly specialized and may require international patient transfer. Burn patients have an increased risk of developing infections. Patients that have been hospitalized in countries where carbapenemase-producing microorganisms (CPMO) are endemic may develop infections that are difficult to treat. In addition, there is a risk on outbreaks with CPMOs in burn centers. This study underlines that burn patients may extensively be colonized with CPMOs, and it provides best practice recommendations regarding clinical microbiology and infection control...
October 23, 2017: European Journal of Clinical Microbiology & Infectious Diseases
https://www.readbyqxmd.com/read/29061148/integrated-community-case-management-by-drug-sellers-influences-appropriate-treatment-of-paediatric-febrile-illness-in-south-western-uganda-a-quasi-experimental-study
#18
Freddy Eric Kitutu, Joan Nakayaga Kalyango, Chrispus Mayora, Katarina Ekholm Selling, Stefan Peterson, Henry Wamani
BACKGROUND: Fever case management is a major challenge for improved child health globally, despite existence of cheap and effective child survival health technologies. The integrated Community Case Management (iCCM) intervention of paediatric febrile illnesses though adopted by Uganda's Ministry of Health to be implemented by community health workers, has not addressed the inaccess to life-saving medicines and diagnostics. Therefore, the iCCM intervention was implemented in private drug shops and evaluated for its effect on appropriate treatment of paediatric fever in a low malaria transmission setting in South Western Uganda...
October 23, 2017: Malaria Journal
https://www.readbyqxmd.com/read/29059253/a-novel-electronic-algorithm-using-host-biomarker-point-of-care-tests-for-the-management-of-febrile-illnesses-in-tanzanian-children-e-poct-a-randomized-controlled-non-inferiority-trial
#19
RANDOMIZED CONTROLLED TRIAL
Kristina Keitel, Frank Kagoro, Josephine Samaka, John Masimba, Zamzam Said, Hosiana Temba, Tarsis Mlaganile, Willy Sangu, Clotilde Rambaud-Althaus, Alain Gervaix, Blaise Genton, Valérie D'Acremont
BACKGROUND: The management of childhood infections remains inadequate in resource-limited countries, resulting in high mortality and irrational use of antimicrobials. Current disease management tools, such as the Integrated Management of Childhood Illness (IMCI) algorithm, rely solely on clinical signs and have not made use of available point-of-care tests (POCTs) that can help to identify children with severe infections and children in need of antibiotic treatment. e-POCT is a novel electronic algorithm based on current evidence; it guides clinicians through the entire consultation and recommends treatment based on a few clinical signs and POCT results, some performed in all patients (malaria rapid diagnostic test, hemoglobin, oximeter) and others in selected subgroups only (C-reactive protein, procalcitonin, glucometer)...
October 2017: PLoS Medicine
https://www.readbyqxmd.com/read/29050043/-malpractice-claims-against-pediatricians-analysis-of-expert-testimonies-from-the-medical-service-of-health-insurance-companies-between-2000-and-2014
#20
Heiko Steinhauer, Joachim Holzschuh, Thomas Böhler
Background In Germany, few data are available on medical malpractice claims against pediatricians. On behalf of Statutory Health Insurance Companies their Medical Service (MDK) regularly offers expert testimony in case of allegations during pediatric treatment. Methods Analysis of 374 written pediatric testimonies, documented between September 1st, 2000 and August 31st, 2014. Results 193 allegations against pediatricians were analysed separately for each sector of care (35% concerning outpatients, 28% normal inpatients, and 37% patients treated in an intensive care unit, ICU)...
November 2017: Klinische Pädiatrie
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