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https://www.readbyqxmd.com/read/29239197/maintaining-quality-in-lower-volume-cardiac-surgery-a-blueprint-from-a-military-program
#1
Jared L Antevil, Philip S Mullenix, Junewai L Reoma, Paul S Massimiano, Frederick C Lough, Eric A Elster
Although there is a clear volume-outcome relationship in the field of cardiac surgery, the existence of high-performing programs with relatively low case volumes is well established. This report describes the programmatic and institutional processes in place at a lower volume cardiac surgery center in a US military hospital, which have been executed to optimally leverage available resources in the delivery of exemplary patient care. By implementing a highly collaborative practice, rigorous outcomes review, evidence-based standardized care pathways, consistent attending surgeon oversight for care delivery, careful case selection, and a mechanism for support from highly experienced outside cardiac surgeons, the cardiac surgery program at the authors' institution delivers care on par with its higher volume counterparts...
December 1, 2017: American Journal of Medical Quality: the Official Journal of the American College of Medical Quality
https://www.readbyqxmd.com/read/29238996/quality-management-of-a-massive-transfusion-protocol
#2
John R Hess, Patrick J Ramos, Nina E Sen, Virginia G Cruz-Cody, Erin E Tuott, Max J Louzon, Eileen M Bulger, Saman Arbabi, Monica B Pagano, Ryan A Metcalf
BACKGROUND: Massive transfusion is a response to massive uncontrolled hemorrhage. To be effective, it must be timely and address the patient's needs for blood volume, oxygen transport, and hemostasis. STUDY DESIGN AND METHODS: A review was performed on all activations of the massive transfusion protocol (MTP) in a hospital with large emergency medicine, trauma, and vascular surgery programs. Indications, transfused amounts, and outcomes were determined for each MTP event to determine appropriateness of MTP use...
December 13, 2017: Transfusion
https://www.readbyqxmd.com/read/29237474/dimethylarginines-in-patients-with-intracerebral-hemorrhage-association-with-outcome-hematoma-enlargement-and-edema
#3
Hans Worthmann, Na Li, Jens Martens-Lobenhoffer, Meike Dirks, Ramona Schuppner, Ralf Lichtinghagen, Jan T Kielstein, Peter Raab, Heinrich Lanfermann, Stefanie M Bode-Böger, Karin Weissenborn
BACKGROUND: Asymmetric dimethylarginine (ADMA)--the most potent endogenous NO-synthase inhibitor, has been regarded as mediator of endothelial dysfunction and oxidative stress. Considering experimental data, levels of ADMA and its structural isomer symmetric dimethylarginine (SDMA) might be elevated after intracerebral hemorrhage (ICH) and associated with clinical outcome and secondary brain injury. METHODS: Blood samples from 20 patients with acute ICH were taken at ≤ 24 h and 3 and 7 days after the event...
December 13, 2017: Journal of Neuroinflammation
https://www.readbyqxmd.com/read/29233593/anterior-mediastinal-tissue-volume-is-correlated-with-antiacetylcholine-receptor-antibody-level-in-myasthenia-gravis
#4
Akihiro Takahagi, Mitsugu Omasa, Toyofumi F Chen-Yoshikawa, Masatsugu Hamaji, Akihiko Yoshizawa, Takashi Sozu, Makoto Sonobe, Hiroshi Date
OBJECTIVES: Extended thymectomy is a treatment option for myasthenia gravis (MG), but the surgical indications are controversial. Pathologic features of the thymus can be used to predict surgical outcomes, but there is no reliable method for evaluating these characteristics preoperatively. The purpose of this study was to determine whether anterior mediastinal tissue volume, as measured via 3-dimensional computed tomography (3DCT) volumetry, correlates with serum anti-acetylcholine receptor antibody (AChRAb) levels in patients undergoing thymectomy for myasthenia gravis...
November 8, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29227461/population-pharmacokinetics-of-lopinavir-in-severely-malnourished-hiv-infected-children-and-the-effect-on-treatment-outcomes
#5
Moherndran Archary, Helen Mcllleron, Raziya Bobat, Phillip La Russa, Thobekile Sibaya, Lubbe Wiesner, Stefanie Hennig
BACKGROUND: In developing countries, malnutrition remains a common clinical syndrome at antiretroviral treatment (ART) initiation. Physiological changes due to malnutrition and during nutritional recovery could affect the pharmacokinetics of antiretroviral drugs. METHODS: HIV-infected children admitted with severe acute malnutrition were randomised to early or delayed initiation of lopinavir/ritonavir, abacavir and lamivudine using WHO weight-band dosage charts...
December 8, 2017: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29225805/hospital-procedure-volume-does-not-predict-acute-kidney-injury-after-coronary-artery-bypass-grafting-a-nationwide-study
#6
Ankit Sakhuja, Kianoush Kashani, Jesse Schold, Wisit Cheungpasitporn, Edward Soltesz, Sevag Demirjian
Background: Acute kidney injury (AKI) is common after coronary artery bypass grafting (CABG) and is associated with poor outcome. Increased hospital procedure volume has been associated with better outcomes. However, the impact of hospital CABG volume on AKI needing dialysis (AKI-D) is less clear. We designed this study to examine (i) the impact of number of annual CABG procedures per hospital (CABG-vol) on AKI-D and inpatient mortality and (ii) if it modifies the relationship between AKI-D and mortality...
December 2017: Clinical Kidney Journal
https://www.readbyqxmd.com/read/29219090/systematic-review-of-the-relationships-between-physical-activity-and-health-indicators-in-the-early-years-0-4%C3%A2-years
#7
Valerie Carson, Eun-Young Lee, Lyndel Hewitt, Cally Jennings, Stephen Hunter, Nicholas Kuzik, Jodie A Stearns, Stephanie Powley Unrau, Veronica J Poitras, Casey Gray, Kristi B Adamo, Ian Janssen, Anthony D Okely, John C Spence, Brian W Timmons, Margaret Sampson, Mark S Tremblay
BACKGROUND: Given the rapid development during the early years (0-4 years), an understanding of the health implications of physical activity is needed. The purpose of this systematic review was to examine the relationships between objectively and subjectively measured physical activity and health indicators in the early years. METHODS: Electronic databases were originally searched in April, 2016. Included studies needed to be peer-reviewed, written in English or French, and meet a priori study criteria...
November 20, 2017: BMC Public Health
https://www.readbyqxmd.com/read/29218064/non-diabetic-hyperglycemia-and-some-of-its-correlates-in-icu-hospitalized-patients-receiving-enteral-nutrition
#8
Mohammad Amin Valizadeh Hasanloei, Zahra Vahdat Shariatpanahi, Davoud Vahabzadeh, Zakaria Vahabzadeh, Leila Nasiri, Ali Shargh
Introduction: Hyperglycemia is a common occurrence in critically ill patients, and its prevalence in patients receiving nutritional support is much higher than in other patients. The non-diabetic form is associated with more undesirable outcomes. This study was performed to determine the prevalence of non-diabetic hyperglycemia and its correlates in patients receiving enteral nutrition. Material and Methods: This cross-sectional study was performed between March and December 2015...
September 2017: Mædica
https://www.readbyqxmd.com/read/29217392/influence-of-traffic-on-build-up-of-polycyclic-aromatic-hydrocarbons-on-urban-road-surfaces-a-bayesian-network-modelling-approach
#9
Yingxia Li, Ziliang Jia, Buddhi Wijesiri, Ningning Song, Ashantha Goonetilleke
Due to their carcinogenic effects, Polycyclic Aromatic Hydrocarbons (PAHs) deposited on urban surfaces are a major concern in the context of stormwater pollution. However, the design of effective pollution mitigation strategies is challenging due to the lack of reliability in stormwater quality modelling outcomes. Current modelling approaches do not adequately replicate the interdependencies between pollutant processes and their influential factors. Using Bayesian Network modelling, this research study characterised the influence of vehicular traffic on the build-up of the sixteen US EPA classified priority PAHs...
December 4, 2017: Environmental Pollution
https://www.readbyqxmd.com/read/29209875/non-routine-discharge-disposition-is-associated-with-post-discharge-complications-and-30-day-readmissions-following-craniotomy-for-brain-tumor-resection
#10
Nikita Lakomkin, Constantinos G Hadjipanayis
Several studies have reported an association between high-volume brain tumor centers and greater rates of routine discharge disposition in the context of better outcomes. However, the relationship between in-hospital complications, discharge destination, and postoperative adverse events (AEs) remains unexplored. The purpose of this study was thus to use a large, prospectively collected database to examine the association between discharge destination, post-discharge complications, readmissions, and reoperations among patients undergoing craniotomy for brain tumor...
December 5, 2017: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29207366/differences-in-approaches-and-outcomes-of-defibrillator-lead-implants-between-high-volume-and-low-volume-operators-results-from-the-pacemaker-and-implantable-defibrillator-leads-survival-study-paidless
#11
Zohaib A Shaikh, Jessica A Chung, Daniel J Kersten, Alyssa M Feldman, Wilbur J Asheld, Joseph Germano, Shahidul Islam, Todd J Cohen
OBJECTIVES: The purpose of this study was to investigate the relationship between operator volume and implantable defibrillator lead failure and patient mortality at a single large implanting center. METHODS: This study analyzed the differences between high-volume and low-volume defibrillator implanters in the Pacemaker and Implantable Defibrillator Lead Survival Study ("PAIDLESS") between February 1, 1996 and December 31, 2011 at NYU Winthrop Hospital. "High-volume" was defined as performing ≥500 implants over the study period, while "low-volume" was defined as performing <500 implants...
December 2017: Journal of Invasive Cardiology
https://www.readbyqxmd.com/read/29205995/volume-and-health-outcomes-evidence-from-systematic-reviews-and-from-evaluation-of-italian-hospital-data
#12
Laura Amato, Danilo Fusco, Anna Acampora, Katia Bontempi, Alessandro Cesare Rosa, Paola Colais, Fabio Cruciani, Mariangela D'Ovidio, Francesca Mataloni, Silvia Minozzi, Zuzana Mitrova, Luigi Pinnarelli, Rosella Saulle, Salvatore Soldati, Chiara Sorge, Simona Vecchi, Martina Ventura, Marina Davoli
BACKGROUND Improving quality and effectiveness of healthcare is one of the priorities of health policies. Hospital or physician volume represents a measurable variable with an impact on effectiveness of healthcare. An Italian law calls for the definition of «qualitative, structural, technological, and quantitative standards of hospital care». There is a need for an evaluation of the available scientific evidence in order to identify qualitative, structural, technological, and quantitative standards of hospital care, including the volume of care above or below which the public and private hospitals may be accredited (or not) to provide specific healthcare interventions...
September 2017: Epidemiologia e Prevenzione
https://www.readbyqxmd.com/read/29203311/lateral-ventricular-volume-asymmetry-predicts-poor-outcome-after-spontaneous-intracerebral-hemorrhage
#13
Jigang Chen, Danfeng Zhang, Zhenxing Li, Yan Dong, Kaiwei Han, Junyu Wang, Lijun Hou
BACKGROUND: Midline shift (MLS) was a known predictor for prognosis after spontaneous intracerebral hemorrhage (ICH), while it's secondary to lateral ventricular compression. In this study, we investigated whether lateral ventricular volume (LVV) asymmetry caused by ventricular compression was associated with poor outcome of ICH independently. METHODS: We retrospectively studied clinical patients with spontaneous ICH from January 2010 to January 2017. LVV was calculated using Slicer software...
December 1, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/29202956/admixture-mapping-of-uterine-fibroid-size-and-number-in-african-american-women
#14
Michael J Bray, Todd L Edwards, Melissa F Wellons, Sarah H Jones, Katherine E Hartmann, Digna R Velez Edwards
OBJECTIVE: To evaluate the relationship between genetic ancestry and uterine fibroid characteristics. DESIGN: Cross-sectional study. SETTING: Not applicable. PATIENT(S): A total of 609 African American participants with image- or surgery-confirmed fibroids in a biorepository at Vanderbilt University electronic health record biorepository and the Coronary Artery Risk Development in Young Adults studies were included. INTERVENTION(S): None...
December 2017: Fertility and Sterility
https://www.readbyqxmd.com/read/29200180/procedural-pain-and-oral-glucose-in-preterm-neonates-brain-development-and-sex-specific-effects
#15
Juliane Schneider, Emma G Duerden, Ting Guo, Karin Ng, Patric Hagmann, Myriam Bickle Graz, Ruth E Grunau, M Mallar Chakravarty, Petra S Hüppi, Anita C Truttmann, Steven P Miller
Our objectives were to determine whether procedural pain and glucose exposure are associated with altered structural and functional brain development differently in preterm males and females, and neurodevelopment at 18-months corrected age. Fifty-one very-preterm neonates (22 males; median[IQR] gestational age 27.6[2.0] weeks) underwent three serial scans including T1-weighted and resting-state functional magnetic resonance imaging (MRI) at median postmenstrual weeks: 29.4, 31.9, and 41.1. Thalamus, basal ganglia, and total brain volumes were segmented...
December 1, 2017: Pain
https://www.readbyqxmd.com/read/29196185/serum-s100a12-and-30-day-mortality-after-acute-intracerebral-hemorrhage
#16
Song-Quan Qian, Su-Rong He, Bei-Bei Li, Jing Qian, Xu-Dong Zheng
BACKGROUND: S100A12 is implicated in inflammatory reactions. The purpose of this study was to determine the association between serum S100A12 concentrations and 30-day mortality in patients with acute intracerebral hemorrhage (ICH). METHODS: We prospectively included 182 healthy controls and 182 ICH patients within 24h after stroke onset. Serum samples were collected for the measurement of S100A12 concentrations. Multivariable analysis was used to evaluate the relationship between serum S100A12 concentrations and mortality of ICH patients within 30days...
November 28, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/29194662/quantitative-predictive-models-for-the-degree-of-disability-after-acute-ischemic-stroke
#17
Hyeong-Seok Lim, Seung Min Kim, Dong-Wha Kang
Although stroke is a leading cause of disability, the quantitative relationship between baseline clinical and imaging characteristics and long-term disability outcomes has rarely been studied. Prospectively collected clinical data from 405 patients with acute ischemic stroke including brain magnetic resonance images (MRIs) and disability outcomes assessed using the modified Rankin Scale (mRS) 3 month after the onset of disease were analyzed using a proportional odds cumulative logit model implemented in NONMEM...
November 30, 2017: Journal of Clinical Pharmacology
https://www.readbyqxmd.com/read/29193080/neuroprotection-mediated-post-ischemically-by-a-non-peptidic-%C3%AE-opioid-receptor-agonist-tan-67-in-ischemic-stroke-mice-is-associated-with-altered-amyloid-precursor-protein-expression-maturation-and-processing
#18
Jia-Wei Min, Yanying Liu, David Wang, Fangfang Qiao, Hongmin Wang
Tan-67 is a selective non-peptidic δ-opioid receptor (DOR) agonist that confers neuroprotection against cerebral ischemia/reperfusion (I/R)-caused neuronal injury in pre-treated animals. In this study, we examined whether post-ischemic administration of Tan-67 in stroke mice is also neuroprotective and whether the treatment affects expression, maturation and processing of the amyloid precursor protein (APP). A focal cerebral I/R model in mice was induced by middle cerebral artery occlusion for 1 hour (h) and Tan-67 (1...
November 29, 2017: Journal of Neurochemistry
https://www.readbyqxmd.com/read/29191764/nursing-home-hospice-collaboration-and-end-of-life-hospitalizations-among-dying-nursing-home-residents
#19
Shubing Cai, Susan C Miller, Pedro L Gozalo
OBJECTIVES: Nursing homes (NHs) collaboration with hospices appears to improve end-of-life (EOL) care among dying NH residents. However, the potential benefits of NH-hospice collaboration may vary with the patterns of this collaboration. This study examines the relationship between the attributes of NH-hospice collaboration, especially the exclusivity of NH-hospice collaboration (ie, the number of hospice providers in a NH), and EOL hospitalizations among dying NH residents. DESIGN: This national retrospective cohort study linked 2000-2009 NH assessments (ie, the Minimum Data Set 2...
November 28, 2017: Journal of the American Medical Directors Association
https://www.readbyqxmd.com/read/29183348/influence-of-breast-compression-pressure-on-the-performance-of-population-based-mammography-screening
#20
Katharina Holland, Ioannis Sechopoulos, Ritse M Mann, Gerard J den Heeten, Carla H van Gils, Nico Karssemeijer
BACKGROUND: In mammography, breast compression is applied to reduce the thickness of the breast. While it is widely accepted that firm breast compression is needed to ensure acceptable image quality, guidelines remain vague about how much compression should be applied during mammogram acquisition. A quantitative parameter indicating the desirable amount of compression is not available. Consequently, little is known about the relationship between the amount of breast compression and breast cancer detectability...
November 28, 2017: Breast Cancer Research: BCR
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