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https://www.readbyqxmd.com/read/28709485/biofilm-colonization-of-mycobacterium-abscessus-new-threat-in-hospital-acquired-surgical-site-infection
#1
Roumi Ghosh, Soumen Das, Harish Kela, Asmita De, Jayeeta Haldar, Prasanta Kumar Maiti
INTRODUCTION: Rapidly growing non-tuberculous mycobacteria (NTM) are hazardous cause of post-operative soft tissue infection leading to nosocomial outbreaks following various surgical procedures, especially laparoscopic surgeries using heat sensitive, non-autoclavable surgical instruments. METHODOLOGY: Surgery department of our hospital noticed increase in rate of post-laparoscopic abdominal port site infection (PSI) and informed the Microbiology Department. A prospective investigational study of defined cases with the aim of source tracing and formulation of infection control measures was initiated...
July 2017: Indian Journal of Tuberculosis
https://www.readbyqxmd.com/read/28707024/experience-of-immediate-ambulation-and-early-discharge-after-tumescent-anesthesia-and-propofol-infusion-in-cosmetic-breast-augmentation
#2
Weiwu Pang, John M Chois, Diana Lambie, Richard Ming-Hui Lin, Zao-Ming Shih
INTRODUCTION: Current cosmetic breast augmentation relies on general anesthesia that normally requires 40 min to total recovery. With experience, the surgical procedure can be completed expediently in 20 min under tumescent anesthesia and propofol full sedation to achieve immediate postoperative ambulation and home discharge readiness, and thus improve patient satisfaction and reduce cost. We retrospectively examined the outcomes of the protocol. MATERIALS AND METHODS: Per protocol, 1200 female patients underwent simple cosmetic breast augmentation accomplished with tumescent anesthesia, immediate mobilization, and early home discharge readiness after surgery...
July 13, 2017: Aesthetic Plastic Surgery
https://www.readbyqxmd.com/read/28699944/improving-the-readability-of-pediatric-hospital-medicine-discharge-instructions
#3
Ndidi Unaka, Angela Statile, Karen Jerardi, Devesh Dahale, Joan Morris, Brianna Liberio, Ashley Jenkins, Blair Simpson, Randi Mullaney, Jodi Kelley, Michelle Durling, Jennifer Shafer, Patrick Brady
BACKGROUND: Readable discharge instructions may help caregivers understand and implement care plans following hospitalization. Many caregivers of hospitalized children, however, have limited literacy. We aimed to increase the percentage of discharge instructions written at 7th grade level or lower for hospital medicine patients from 13% to 80% in 6 months. METHODS: Quality improvement efforts targeted a 42-bed unit at the community satellite of our large, urban academic hospital...
July 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28697297/general-practitioner-follow-up-in-older-patients-after-an-emergency-department-admission
#4
Belinda Watson, Chun Wah Michael Tam, Belinda Pellizzon, Lucille Ban, Harry Doan
BACKGROUND: Few studies have investigated older patients with regards to general practice follow-up after an emergency department (ED) admission. We measured the proportion of older patients given explicit general practice follow-up instructions who sought care by day seven after an ED admission. METHODS: Patients discharged from Fairfield Hospital ED (south-western Sydney) who were 65 years and older were approached for a structured telephone interview. Data from the interview and patients' ED discharge summaries were analysed descriptively...
2017: Australian Family Physician
https://www.readbyqxmd.com/read/28682971/loop-ileostomy-closure-as-an-overnight-procedure-institutional-comparison-with-the-national-surgical-quality-improvement-project-data-set
#5
Nicholas G Berger, Raymond Chou, Elliot S Toy, Kirk A Ludwig, Timothy J Ridolfi, Carrie Y Peterson
BACKGROUND: Enhanced recovery pathways have decreased length of stay after colorectal surgery. Loop ileostomy closure remains a challenge, because patients experience high readmission rates, and validation of enhanced recovery pathways has not been demonstrated. This study examined a protocol whereby patients were discharged on the first postoperative day and instructed to advance their diet at home with close telephone follow-up. OBJECTIVE: The hypothesis was that patients can be safely discharged the day after loop closure, leading to shorter length of stay without increased rates of readmission or complications...
August 2017: Diseases of the Colon and Rectum
https://www.readbyqxmd.com/read/28678122/all-cause-versus-complication-specific-readmission-following-total-knee-arthroplasty
#6
Michele D'Apuzzo, Geoffrey Westrich, Chisa Hidaka, Ting Jung Pan, Stephen Lyman
BACKGROUND: Unplanned readmissions have become an important quality indicator, particularly for reimbursement; thus, accurate assessment of readmission frequency and risk factors for readmission is critical. The purpose of this study was to determine (1) the frequency of and (2) risk factors for readmissions for all causes or procedure-specific complications within 30 days after total knee arthroplasty (TKA) as well as (3) the association between hospital volume and readmission rate. METHODS: The Statewide Planning and Research Cooperative System (SPARCS) database from the New York State Department of Health was used to identify 377,705 patients who had undergone primary TKA in the period from 1997 to 2014...
July 5, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28660551/infants-with-head-injuries-do-all-need-hospital-admission
#7
B Rai, F McCartan, A Kaninde, F Sharif
BACKGROUND: Head injury in a young infant is a common presentation in paediatric emergency departments and clinicians often admit these young infants (less than 12 months of age) for further neuro-observation due to lack of strong evidence base and standard recommendations about the management of such a young patient with head injury. AIMS: We performed this retrospective observational study to find out whether inpatient admission is really necessary in those infants who present with minor head injury to the paediatric emergency departments...
June 28, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28658159/outcomes-of-primary-gastric-transposition-for-long-gap-esophageal-atresia-in-neonates
#8
Zhandong Zeng, Fengli Liu, Juan Ma, Yun Fang, Hongwei Zhang
BACKGROUND: Gastric transposition is a relatively novel method of esophageal replacement. The purpose of this retrospective study was to assess the outcomes of long-gap esophageal atresia (LGEA) treated with esophageal replacement using primary gastric transposition in neonates. METHODS: Between March 2008 and May 2015, 14 newborns with LGEA were treated in our hospital. They were all found to have gaps of over 3 cm at the time of the surgery and were diagnosed with LGEA...
June 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/28655625/impact-of-city-police-layperson-education-and-equipment-with-automatic-external-defibrillators-on-patient-outcome-after-out-of-hospital-cardiac-arrest
#9
Philipp Stein, Gabriela H Spahn, Stefan Müller, Andreas Zollinger, Werner Baulig, Martin Brüesch, Burkhardt Seifert, Donat R Spahn
INTRODUCTION: Out of hospital cardiac arrest (OHCA) occurs frequently and the outcome is often dismal. Early defibrillation saves lives and brain function in OHCA. The Zurich city police (STAPO) forces were instructed and equipped to provide basic life support (BLS) and to use an AED in 2009. METHODS: Retrospective observational study comparing period 1 (P1) 2004-2009 before equipping and training of the STAPO and period 2 (P2) 2010-2015 after the implementation...
June 24, 2017: Resuscitation
https://www.readbyqxmd.com/read/28651885/use-of-antibiotic-beads-to-salvage-infected-breast-implants
#10
Rami D Sherif, Michael Ingargiola, Paymon Sanati-Mehrizy, Philip J Torina, Marco A Harmaty
PURPOSE: When an implant becomes infected, implant salvage is often performed where the implant is removed, capsulectomy is performed, and a new implant is inserted. The patient is discharged with a PICC line and 6-8 weeks of intravenous (IV) antibiotics. This method has variable success and subjects the patient to long-term systemic antibiotics. In the 1960s, the use of antibiotic-impregnated beads for the treatment of chronic osteomyelitis was described. These beads deliver antibiotic directly to the site of the infection, thereby eliminating the complications of systemic IV antibiotics...
May 22, 2017: Journal of Plastic, Reconstructive & Aesthetic Surgery: JPRAS
https://www.readbyqxmd.com/read/28641378/staff-perceptions-of-key-factors-guiding-nursing-home-search-and-selection-within-the-veterans-health-administration
#11
Edward Alan Miller, Stefanie Gidmark, Emily Gadbois, James L Rudolph, Orna Intrator
Background and Objectives: Veterans enter nursing homes (NHs) for short-term postacute, rehabilitation, respite, or end-of-life care. They also enter NHs on a long-term basis due to frailty, disability, functional deficits, and cognitive impairment. Little is known about how a particular NH is chosen once the decision to enter a NH has been made. This study identified VA staff perceptions of the key factors influencing the search and selection of NHs within the Veterans Health Administration (VHA)...
June 21, 2017: Gerontologist
https://www.readbyqxmd.com/read/28632589/emergency-department-visits-following-elective-total-hip-and-knee-replacement-surgery-identifying-gaps-in-continuity-of-care
#12
Micaela A Finnegan, Robyn Shaffer, Austin Remington, Jereen Kwong, Catherine Curtin, Tina Hernandez-Boussard
BACKGROUND: Major joint replacement surgical procedures are common, elective procedures with a care episode that includes both inpatient readmissions and postoperative emergency department (ED) visits. Inpatient readmissions are well studied; however, to our knowledge, little is known about ED visits following these procedures. We sought to characterize 30-day ED visits following a major joint replacement surgical procedure. METHODS: We used administrative records from California, Florida, and New York, from 2010 through 2012, to identify adults undergoing total knee and hip arthroplasty...
June 21, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28625669/role-of-language-discordance-in-complication-and-readmission-rate-after-infrainguinal-bypass
#13
Elica Inagaki, Alik Farber, Jeffrey Kalish, Jeffrey J Siracuse, Clara Zhu, Denis V Rybin, Gheorghe Doros, Mohammad H Eslami
OBJECTIVE: Studies have shown that language discordance between treatment teams and patients leads to worse patient outcomes, including longer hospital stays, higher rates of readmission, impaired comprehension of discharge instructions, and lower treatment adherence. Yet, there is a paucity of data evaluating the effects of language discordance on postoperative outcomes among vascular surgery patients. This study compared 30-day postoperative complications and readmissions after nonemergent infrainguinal bypass between non-English-speaking (NES) and English-speaking (ES) patients...
June 16, 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28591974/schedules-of-controlled-substances-placement-of-acetyl-fentanyl-into-schedule-i-final-order
#14
(no author information available yet)
With the issuance of this final order, the Administrator of the Drug Enforcement Administration will maintain the placement of the substance acetyl fentanyl (N-(1-phenethylpiperidin-4-yl)-N-phenylacetamide), including its isomers, esters, ethers, salts, and salts of isomers, esters and ethers, in schedule I of the Controlled Substances Act. This scheduling action is pursuant to the Controlled Substances Act and is required in order for the United States to discharge its obligations under the Single Convention on Narcotic Drugs, 1961...
June 7, 2017: Federal Register
https://www.readbyqxmd.com/read/28590385/post-discharge-care-duration-charges-and-outcomes-among-medicare-patients-after-primary-total-hip-and-knee-arthroplasty
#15
Karthikeyan E Ponnusamy, Zan Naseer, Mostafa H El Dafrawy, Louis Okafor, Clayton Alexander, Robert S Sterling, Harpal S Khanuja, Richard L Skolasky
BACKGROUND: In April 2016, the U.S. Centers for Medicare & Medicaid Services initiated mandatory 90-day bundled payments for total hip and knee arthroplasty for much of the country. Our goal was to determine duration of care, 90-day charges, and readmission rates by discharge disposition and U.S. region after hip or knee arthroplasty. METHODS: Using the 2008 Medicare Provider Analysis and Review database 100% sample, we identified patients who had undergone elective primary total hip or knee arthroplasty...
June 7, 2017: Journal of Bone and Joint Surgery. American Volume
https://www.readbyqxmd.com/read/28573408/practical-recommendations-for-transitioning-patients-with-type-2-diabetes-from-hospital-to-home
#16
REVIEW
Amy C Donihi
PURPOSE OF REVIEW: The purpose of this review is to provide practical evidence-based recommendations for transitioning hospitalized patients with type 2 diabetes (T2DM) to home. RECENT FINDINGS: Hospitalized patients who have newly diagnosed or poorly controlled T2DM require initiation or intensification of their outpatient diabetes regimen. Potential barriers to medication access and continuity of care should be identified early in the hospitalization. Throughout hospitalization, patients should receive diabetes education focused on basic survival skills and tailored to learning needs...
July 2017: Current Diabetes Reports
https://www.readbyqxmd.com/read/28557755/validation-of-new-quality-measures-for-transitions-between-sites-of-care
#17
Layla Parast, Q Burkhart, Arti D Desai, Tamara D Simon, Carolyn Allshouse, Maria T Britto, JoAnna K Leyenaar, Courtney A Gidengil, Sara L Toomey, Marc N Elliott, Eric C Schneider, Rita Mangione-Smith
BACKGROUND AND OBJECTIVE: Assessing and improving the quality of transitions to home from the emergency department (ED) or hospital is critical for patient safety. Our objective was to validate 8 newly developed caregiver-reported measures of transition quality. METHODS: This prospective observational study included 1086 caregiver survey respondents whose children had an ED visit (n = 523) or hospitalization (n = 563) at Seattle Children's Hospital in 2014. Caregivers were contacted to complete 2 surveys...
May 2017: Pediatrics
https://www.readbyqxmd.com/read/28538458/continuous-femoral-nerve-catheters-decrease-opioid-related-side-effects-and-increase-home-disposition-rates-among-geriatric-hip-fracture-patients
#18
Diren Arsoy, Michael J Gardner, Derek F Amanatullah, James I Huddleston, Stuart B Goodman, William J Maloney, Julius A Bishop
OBJECTIVE: To evaluate the effect of continuous femoral nerve catheter (CFNC) for postoperative pain control in geriatric proximal femur fractures compared with standard analgesia (SA) treatment. DESIGN: Retrospective comparative study. SETTING: Academic Level 1 trauma center. PATIENTS/PARTICIPANTS: We retrospectively identified 265 consecutive geriatric hip fracture patients who underwent surgical treatment. INTERVENTION: One hundred forty-nine patients were treated with standard analgesia without nerve catheter whereas 116 patients received an indwelling CFNC...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28538457/patterns-of-opioid-prescribing-for-an-orthopaedic-trauma-population
#19
John Ruder, Meghan K Wally, McKell Oliverio, Rachel B Seymour, Joseph R Hsu
OBJECTIVES: To determine opioid-prescribing practices to the orthopaedic trauma (OT) population at one Level I trauma center. DESIGN: A retrospective study of discharge prescriptions for adult patients with OT. Prescription details, injury burden, and patient demographics were abstracted for patients from initial injury through a 2-month follow-up. SETTING: Level I trauma center. PATIENTS/PARTICIPANTS: Adult patients with OT admitted over a 30-day period (n = 110)...
June 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/28530310/-drug-therapy-following-bariatric-surgery-examination-of-potential-impact-and-clinical-recommendations
#20
REVIEW
Carmil Azran, Arik Dahan
Bariatric surgery is the most effective solution for morbid obesity, and the number of patients undergoing bariatric surgery is rapidly and constantly growing. The modified gastrointestinal (GI) anatomy of the patient may lead to significant pharmacokinetic alterations in the oral absorption of drugs after surgery. However, due to insufficient available literature and inadequate awareness of the medical team, bariatric surgery patients may be discharged from the hospital with insufficient instructions regarding their medication therapy...
January 2017: Harefuah
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