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https://www.readbyqxmd.com/read/28110412/prevention-of-cardiac-surgery-associated-aki-by-implementing-the-kdigo-guidelines-in-high-risk-patients-identified-by-biomarkers-the-prevaki-randomized-controlled-trial
#1
Melanie Meersch, Christoph Schmidt, Andreas Hoffmeier, Hugo Van Aken, Carola Wempe, Joachim Gerss, Alexander Zarbock
PURPOSE: Care bundles are recommended in patients at high risk for acute kidney injury (AKI), although they have not been proven to improve outcomes. We sought to establish the efficacy of an implementation of the Kidney Disease Improving Global Outcomes (KDIGO) guidelines to prevent cardiac surgery-associated AKI in high risk patients defined by renal biomarkers. METHODS: In this single-center trial, we examined the effect of a "KDIGO bundle" consisting of optimization of volume status and hemodynamics, avoidance of nephrotoxic drugs, and preventing hyperglycemia in high risk patients defined as urinary [TIMP-2]·[IGFBP7] > 0...
January 21, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28110379/-they-are-talking-about-me-but-not-with-me-a-focus-group-study-to-explore-the-patient-perspective-on-interprofessional-team-meetings-in-primary-care
#2
Jerôme Jean Jacques van Dongen, Maarten de Wit, Hester Wilhelmina Henrica Smeets, Esther Stoffers, Marloes Amantia van Bokhoven, Ramon Daniëls
BACKGROUND: The number of people with multiple chronic conditions receiving primary care services is growing. To deal with their increasingly complex health care demands, professionals from different disciplines need to collaborate. Interprofessional team (IPT) meetings are becoming more popular. Several studies describe important factors related to conducting IPT meetings, mostly from a professional perspective. However, in the light of patient-centeredness, it is valuable to also explore the patients' perspective...
January 21, 2017: Patient
https://www.readbyqxmd.com/read/28110290/guided-and-unguided-internet-based-vestibular-rehabilitation-versus-usual-care-for-dizzy-adults-of-50%C3%A2-years-and-older-a-protocol-for-a-three-armed-randomised-trial
#3
Vincent A van Vugt, Johannes C van der Wouden, Judith E Bosmans, Martin Smalbrugge, Willianne van Diest, Rosie Essery, Lucy Yardley, Henriëtte E van der Horst, Otto R Maarsingh
INTRODUCTION: Dizziness is a common symptom in general practice with a high prevalence among older adults. The most common cause of dizziness in general practice is peripheral vestibular disease. Vestibular rehabilitation (VR) is a safe and effective treatment for peripheral vestibular disease that entails specific exercises to maximise the central nervous system compensation for the effects of vestibular pathology. An internet-based VR intervention has recently been shown to be safe and effective...
January 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28110287/aspirin-to-inhibit-sepsis-antisepsis-randomised-controlled-trial-protocol
#4
Damon P Eisen, Elizabeth M Moore, Karin Leder, Jessica Lockery, Emma S McBryde, John J McNeil, David Pilcher, Rory Wolfe, Robyn L Woods
INTRODUCTION: Sepsis is a leading global cause of morbidity and mortality, and is more common at the extremes of age. Moreover, the cost of in-hospital care for elderly patients with sepsis is significant. There are indications from experimental and observational studies that aspirin may reduce inflammation associated with infection. This paper describes the rationale and design of the AspiriN To Inhibit SEPSIS (ANTISEPSIS) trial, a substudy of ASPirin in Reducing Events in the Elderly (ASPREE)...
January 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28110285/validation-of-a-clinical-screening-instrument-for-tumour-predisposition-syndromes-in-patients-with-childhood-cancer-tups-protocol-for-a-prospective-observational-multicentre-study
#5
Floor A M Postema, Saskia M J Hopman, Corianne A J M de Borgie, Peter Hammond, Raoul C Hennekam, Johannes H M Merks, Cora M Aalfs, Jakob K Anninga, Lieke Pv Berger, Fonnet E Bleeker, Eveline Sjm de Bont, Corianne Ajm de Borgie, Charlotte J Dommering, Natasha Ka van Eijkelenburg, Peter Hammond, Raoul C Hennekam, Marry M van den Heuvel-Eibrink, Saskia Mj Hopman, Marjolijn Cj Jongmans, Wijnanda A Kors, Tom Gw Letteboer, Jan Lcm Loeffen, Johannes Hm Merks, Maran Jw Olderode-Berends, Floor Am Postema, Anja Wagner
INTRODUCTION: Recognising a tumour predisposition syndrome (TPS) in patients with childhood cancer is of significant clinical relevance, as it affects treatment, prognosis and facilitates genetic counselling. Previous studies revealed that only half of the known TPSs are recognised during standard paediatric cancer care. In current medical practice it is impossible to refer every patient with childhood cancer to a clinical geneticist, due to limited capacity for routine genetic consultation...
January 20, 2017: BMJ Open
https://www.readbyqxmd.com/read/28110270/assessment-of-neonatal-pain-during-heel-prick-lancet-vs-needle-a-randomized-controlled-study
#6
Carl Britto, Suman P N Rao
BACKGROUND: Heel prick is a frequent painful procedure in newborns. A lancet or a 26-gauge needle is used for a heel prick in India. OBJECTIVE: To compare the pain caused by heel prick with a lancet or a 26-gauge needle in newborns admitted in the neonatal intensive care unit (NICU) using the preterm infant pain profile (PIPP). METHODS: This randomized controlled trial was conducted over 2 months in a Level III NICU with a sample size of 40 subjects (20 in each group), which was required for the study to have a power of 80% with an alpha error of 0...
January 21, 2017: Journal of Tropical Pediatrics
https://www.readbyqxmd.com/read/28110098/clinical-manifestations-of-helicobacter-pylori-negative-gastritis
#7
Seiji Shiota, Aaron P Thrift, Linda Green, Rajesh Shah, Gordana Verstovsek, Massimo Rugge, David Y Graham, Hashem B El-Serag
OBJECTIVES: There are data to suggest the existence of non-H. pylori gastritis. However, the risk factors and clinical course for H. pylori-negative gastritis remain unclear. We aimed to examine the prevalence and determinants of H. pylori-negative gastritis in a large multiethnic clinical population. METHOD: We conducted a cross-sectional study among patents scheduled for an elective esophagastroduodenoscopy or attending selected primary care clinics and eligible for screening colonoscopy at a single VA medical center...
January 18, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28110095/prophylaxis-for-stress-ulcers-with-proton-pump-inhibitors-is-not-associated-with-increased-risk-of-bloodstream-infections-in-the-intensive-care-unit
#8
Margot E Cohen, Joanne M Hathway, Hojjat Salmasian, Jianfang Liu, Melissa Terry, Julian A Abrams, Daniel E Freedberg
BACKGROUND & AIMS: Proton pump inhibitors (PPIs) have been associated with increased risk of infection, likely due to changes in intestinal epithelial permeability and the gastrointestinal microbiome. PPIs are frequently given to patients in the intensive care unit (ICU) to prevent stress ulcers. These patients are at risk for bloodstream infections (BSIs), so we investigated the relationship between PPI use and BSIs among patients in the ICU. METHODS: We performed a retrospective cohort study of adults (≥18 years) admitted to 1 of 14 ICUs within a hospital network of 3 large hospitals from 2008 through 2014...
January 18, 2017: Clinical Gastroenterology and Hepatology
https://www.readbyqxmd.com/read/28110055/adverse-and-hypersensitivity-reactions-to-prescription-nonsteroidal-anti-inflammatory-agents-in-a-large-health-care-system
#9
Kimberly G Blumenthal, Kenneth H Lai, Mingshu Huang, Zachary S Wallace, Paige G Wickner, Li Zhou
BACKGROUND: Nonsteroidal anti-inflammatory drugs (NSAIDs) are among the most frequently used medications in the United States. NSAID use can be limited by adverse drug reactions (ADRs), including hypersensitivity reactions (HSRs). OBJECTIVE: We aimed to use electronic health record data to determine the incidence and predictors of HSRs to prescription NSAIDs. METHODS: We performed a retrospective cohort study of all adult outpatients in a large health care system prescribed diclofenac, indomethacin, nabumetone, or piroxicam between January 1, 2004, and September 30, 2012...
January 18, 2017: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/28109998/impact-of-mean-arterial-pressure-on-clinical-outcomes-in-comatose-survivors-of-out-of-hospital-cardiac-arrest-insights-from-the-university-of-ottawa-heart-institute-regional-cardiac-arrest-registry-capital-care
#10
Juan J Russo, Tyler E James, Benjamin Hibbert, Altayyeb Yousef, Christina Osborne, George A Wells, Michael P V Froeschl, Derek Y So, Aun Yeong Chong, Marino Labinaz, Chris A Glover, Jean-François Marquis, Alexander Dick, Jordan Bernick, Michel R Le May
AIM: of the study We sought to assess the relationship between mean arterial pressure (MAP) and clinical outcomes in comatose survivors of out-of-hospital cardiac arrest (OHCA). METHODS: We identified consecutive comatose survivors of OHCA with an initial shockable rhythm treated with targeted temperature management. We examined clinical outcomes in relation to mean MAP (measured hourly) during the first 96hours of hospitalization. Mean MAP was examined as both a continuous variable and a categorical variable consisting of 3 pre-specified strata: <70mmHg, 70 to <80mmHg, and ≥80mmHg...
January 18, 2017: Resuscitation
https://www.readbyqxmd.com/read/28109804/increasing-rates-of-no-treatment-in-advanced-stage-non-small-cell-lung-cancer-patients-a%C3%A2-propensity-matched-analysis
#11
Elizabeth A David, Megan E Daly, Chin-Shang Li, Chi-Lu Chiu, David T Cooke, Lisa M Brown, Joy Melnikow, Karen Kelly, Robert J Canter
INTRODUCTION: Variation in treatment and survival outcomes for NSCLC is high among patients with stage III or IV disease, but patients with untreated NSCLC have not been critically analyzed to evaluate for improvable outcomes. We evaluated treatment trends and their association with oncologic outcomes for NSCLC, hypothesizing that there are a substantial number of untreated patients who are similar to patients who undergo treatment. METHODS: Linear regression was used to calculate trends in utilization of treatment...
January 18, 2017: Journal of Thoracic Oncology
https://www.readbyqxmd.com/read/28109735/implementation-and-evaluation-of-two-educational-strategies-to-improve-screening-for-eating-disorders-in-pediatric-primary-care
#12
Holly C Gooding, Elizabeth Cheever, Sara F Forman, Jonathan Hatoun, Farah Jooma, Currie Touloumtzis, Louis Vernacchio
PURPOSE: Routine screening for disordered eating or body image concerns is recommended by the American Academy of Pediatrics. We evaluated the ability of two educational interventions to increase screening for eating disorders in pediatric primary care practice, predicting that the "active-learning" group would have an increase in documented screening after intervention. METHODS: We studied 303 practitioners in a large independent practice association located in the northeastern United States...
January 18, 2017: Journal of Adolescent Health: Official Publication of the Society for Adolescent Medicine
https://www.readbyqxmd.com/read/28109628/preoperative-bathing-of-the-surgical-site-with-chlorhexidine-for-infection-prevention-systematic-review-with-meta-analysis
#13
Lúcia Maciel de Castro Franco, Gláucia Fernandes Cota, Tatiana Saraiva Pinto, Flávia Falci Ercole
BACKGROUND: Preoperative bathing with 4% chlorhexidine is recommended as a measure to prevent surgical site infection (SSI) despite uncertainty regarding the effectiveness of the intervention. This review aimed to assess the effect of bathing with 4% chlorhexidine on the prevention of SSIs in clean surgeries compared with bathing with placebo solution or soap. METHODS: Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines for systematic reviews and the Cochrane manual were followed...
January 18, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28109562/primary-cesarean-delivery-patterns-among-women-with-physical-sensory-or-intellectual-disabilities
#14
Blair G Darney, Frances M Biel, Brian P Quigley, Aaron B Caughey, Willi Horner-Johnson
BACKGROUND: Little is known about the relationship between disability and mode of delivery. Prior research has indicated elevated risk of cesarean delivery among women with certain disabilities, but has not examined patterns across multiple types of disability or by parity. OBJECTIVE: This study sought to determine whether physical, sensory, or intellectual and developmental disabilities are independently associated with primary cesarean delivery. METHODS: We conducted a retrospective cohort study of all deliveries in California from 2000 to 2010 using linked birth certificate and hospital discharge data...
January 18, 2017: Women's Health Issues: Official Publication of the Jacobs Institute of Women's Health
https://www.readbyqxmd.com/read/28109560/etiologies-trends-and-predictors-of-30-day-readmission-in-patients-with-heart-failure
#15
Shilpkumar Arora, Prashant Patel, Sopan Lahewala, Nilay Patel, Nileshkumar J Patel, Kosha Thakore, Aditi Amin, Byomesh Tripathi, Varun Kumar, Harshil Shah, Mahek Shah, Sidakpal Panaich, Abhishek Deshmukh, Apurva Badheka, Umesh Gidwani, Radha Gopalan
Heart failure (HF) is the most common discharge diagnosis across the United States, and these patients are particularly vulnerable to readmissions, increasing attention to potential ways to address the problem. The study cohort was derived from the Healthcare Cost and Utilization Project's National Readmission Data 2013, sponsored by the Agency for Healthcare Research and Quality. HF was identified using appropriate International Classification of Diseases, Ninth Revision, Clinical Modification codes. Readmission was defined as a subsequent hospital admission within 30 days after discharge day of index admission...
December 14, 2016: American Journal of Cardiology
https://www.readbyqxmd.com/read/28109467/dexamethasone-in-head-and-neck-cancer-patients-with-microvascular-reconstruction-no-benefit-more-complications
#16
S Kainulainen, J Törnwall, A M Koivusalo, A L Suominen, P Lassus
OBJECTIVES: Glucocorticoids are widely used in association with major surgery of the head and neck to improve postoperative rehabilitation, shorten intensive care unit and hospital stay, and reduce neck swelling. This study aimed to clarify whether peri- and postoperative use of dexamethasone in reconstructive head and neck cancer surgery is associated with any advantages or disadvantages. MATERIALS AND METHODS: This prospective double-blind randomized controlled trial comprised 93 patients...
February 2017: Oral Oncology
https://www.readbyqxmd.com/read/28109324/reporting-of-critical-care-trial-abstracts-a-comparison-before-and-after-the-announcement-of-consort-guideline-for-abstracts
#17
Akira Kuriyama, Naomi Takahashi, Takeo Nakayama
BACKGROUND: An extension of the Consolidated Standards of Reporting Trials (CONSORT) statement provides a checklist of items to improve the reporting quality of abstracts of randomized controlled trials (RCTs). However, authors of abstracts in some fields have poorly adhered to this guideline. We did an extensive literature survey to examine the quality of reporting trial abstracts in major critical care journals before and after announcement of the CONSORT guideline for abstracts. METHODS: We reviewed abstracts of RCTs published in four major critical care journals with publication dates ranging from 2006 to 2007 (pre-CONSORT) and from 2011 to 2012 (post-CONSORT): Intensive Care Medicine (ICM), Critical Care (CC), American Journal of Respiratory and Critical Care Medicine (AJRCCM), and Critical Care Medicine (CCM)...
January 21, 2017: Trials
https://www.readbyqxmd.com/read/28109313/can-an-educational-podcast-improve-the-ability-of-parents-of-primary-school-children-to-assess-the-reliability-of-claims-made-about-the-benefits-and-harms-of-treatments-study-protocol-for-a-randomised-controlled-trial
#18
Daniel Semakula, Allen Nsangi, Matt Oxman, Astrid Austvoll-Dahlgren, Sarah Rosenbaum, Margaret Kaseje, Laetitia Nyirazinyoye, Atle Fretheim, Iain Chalmers, Andrew D Oxman, Nelson K Sewankambo
BACKGROUND: Claims made about the effects of treatments are very common in the media and in the population more generally. The ability of individuals to understand and assess such claims can affect their decisions and health outcomes. Many people in both low- and high-income countries have inadequate aptitude to assess information about the effects of treatments. As part of the Informed Healthcare Choices project, we have prepared a series of podcast episodes to help improve people's ability to assess claims made about treatment effects...
January 21, 2017: Trials
https://www.readbyqxmd.com/read/28109281/evaluation-of-a-program-to-strengthen-general-practice-care-for-patients-with-chronic-disease-in-germany
#19
Michel Wensing, Joachim Szecsenyi, Christian Stock, Petra Kaufmann Kolle, Gunter Laux
BACKGROUND: A program to strengthen general practice care for patients with chronic disease was offered in Germany. Enrollment was a free individual choice for both patients and physicians. This study aimed to examine the long-term impact of this program. METHODS: Two comparative evaluations were done, at 4 and 5 years (T1 and T2) after start of the program. In each year, patients in the program were compared with patients in usual care. Measures were based on routinely collected data and concerned 11 aspects of primary care and hospital care...
January 21, 2017: BMC Health Services Research
https://www.readbyqxmd.com/read/28109279/a-comparative-analysis-of-centralized-waiting-lists-for-patients-without-a-primary-care-provider-implemented-in-six-canadian-provinces-study-protocol
#20
Mylaine Breton, Michael Green, Sara Kreindler, Jason Sutherland, Jalila Jbilou, Sabrina T Wong, Jay Shaw, Valorie A Crooks, Damien Contandriopoulos, Mélanie Ann Smithman, Astrid Brousselle
BACKGROUND: Having a regular primary care provider (i.e., family physician or nurse practitioner) is widely considered to be a prerequisite for obtaining healthcare that is timely, accessible, continuous, comprehensive, and well-coordinated with other parts of the healthcare system. Yet, 4.6 million Canadians, approximately 15% of Canada's population, are unattached; that is, they do not have a regular primary care provider. To address the critical need for attachment, especially for more vulnerable patients, six Canadian provinces have implemented centralized waiting lists for unattached patients...
January 21, 2017: BMC Health Services Research
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