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Two midnight

Vaughn E Nossaman, William S Richardson, James B Wooldridge, Bobby D Nossaman
INTRODUCTION: A recent bariatric surgical study demonstrated an inverse relationship of intraoperative hydration with the incidence of extended hospital length of stay (ehLOS: >1 postoperative hospital day). In that study, a post hoc analysis of the preoperative duration of Nil Per Os (NPO) past midnight revealed a significant dose-response association on the incidence of ehLOS, with the lowest incidence (10-12 %) predicted within the 2-5-h NPO interval. As NPO is associated with a state of compensatory dehydration, the objectives of this study were to prospectively examine the role of decreasing preoperative NPO intervals on the incidence of ehLOS in a similar bariatric surgical population and to establish causality of this association...
September 27, 2016: Surgical Endoscopy
Mojtaba Malek, Fatemeh Esfehanian, Atieh Amouzegar, Farzaneh Sarvghadi, Zohreh Moossavi, Mohammad R Mohajeri-Tehrani, Mohammad E Khamseh, Alireza Amirbaigloo, Ameneh Ebrahim Valojerdi
BACKGROUND: Cushing's disease is the most prevalent cause of endogenous adrenocorticotrophic hormone hypersecretion. The aim of this study was to document the current clinical practice pattern in the management of Cushing's disease by Iranian Endocrinologists to determine their opinions and compare them with the current clinical practice guidelines. METHODS: An eight-item questionnaire dealing with diagnosis, treatment and follow up of patients with Cushing's disease was developed, piloted, and sent to the members of Iranian Endocrinology Society...
2016: Medical Journal of the Islamic Republic of Iran
Fuqin Liu, Jiaming Bao, Doris Boutain, Marcia Straughn, Olusola Adeniran, Heather DeGrande, Stevan Harrell
AIM: A critical analysis of online public postings in response to the news about the ending of China's one-child policy was conducted. The specific study aims were to 1) identify the dominant public discourse in response to the news about the ending of the one-child policy and the beginning of the new two-child policy, and 2) explore implications for preconception care from the public discourse. MATERIAL AND METHODS: Data sources were 10 top-ranked, online news media sites in China, including one Hong Kong-based media site...
June 24, 2016: Upsala Journal of Medical Sciences
(no author information available yet)
No abstract text is available yet for this article.
June 2016: Hospital Case Management: the Monthly Update on Hospital-based Care Planning and Critical Paths
Toni Cesta
While the Two-Midnight Rule can be confusing to staff and patients alike, if you implement and hardwire your processes you will be more likely to maintain compliance going forward.
June 2016: Hospital Case Management: the Monthly Update on Hospital-based Care Planning and Critical Paths
Seyed Hamid Moosavy, Mehran Shahi, Javad Rafinejad, Shahram Zare, Abdoulhossain Madani, Shahrokh Navidpour
INTRODUCTION: People in tropical and semi-tropical areas are in danger of scorpion sting, and this can be a serious problem for them. Mortality due to scorpion sting in the tropical and semi-tropical areas of Iran is about 75%, and this makes scorpion sting in these areas a serious medical problem. Because of this problem, our aim was to assess the epidemiological aspects of scorpion sting in Bandar Abbas, Iran, during 2009-2011. METHODS: In this cross-sectional retrospective study, epidemiologic data of 698 scorpion sting cases, who were referred to the Shahid Mohamadi Hospital of Bandar Abbas in Hormozgan Province collected from 2009 until 2011...
April 2016: Electronic Physician
Eva O Melin, Ralph Svensson, Sven-Åke Gustavsson, Agneta Winberg, Ewa Denward-Olah, Mona Landin-Olsson, Hans O Thulesius
BACKGROUND: Depression is linked with alexithymia, anxiety, high HbA1c concentrations, disturbances of cortisol secretion, increased prevalence of diabetes complications and all-cause mortality. The psycho-educational method 'affect school with script analysis' and the mind-body therapy 'basic body awareness treatment' will be trialled in patients with diabetes, high HbA1c concentrations and psychological symptoms. The primary outcome measure is change in symptoms of depression. Secondary outcome measures are changes in HbA1c concentrations, midnight salivary cortisol concentration, symptoms of alexithymia, anxiety, self-image measures, use of antidepressants, incidence of diabetes complications and mortality...
2016: Trials
Aaron M Potretzke, Eric H Kim, Brent A Knight, Barrett G Anderson, Alyssa M Park, R Sherburne Figenshau, Sam B Bhayani
We sought to examine the impact of baseline patient characteristics and perioperative outcomes on postoperative hospital length of stay (LOS), following the robot-assisted radical prostatectomy (RARP). We retrospectively reviewed consecutive patients receiving RARP at our institution by two surgeons between January 2012 and March 2014 (n = 274). Baseline patient characteristics were collected, including Charlson comorbidity index (CCI). Discharge criteria were identical for all patients and included: return of bowel function, pain controlled with oral medications, and ambulation without assistance...
June 2016: Journal of Robotic Surgery
Vinita Ollapally
No abstract text is available yet for this article.
March 2016: Bulletin of the American College of Surgeons
M Á Royo-Bordonada, K León-Flández, J Damián, M J Bosqued-Estefanía, M Á Moya-Geromini, L López-Jurado
OBJECTIVE: To examine the extent and nature of food television advertising directed at children in Spain using an international food-based system and the United Kingdom nutrient profile model (UKNPM). STUDY DESIGN: Cross-sectional study of advertisements of food and drinks shown on five television channels over 7 days in 2012 (8am-midnight). METHODS: Showing time and duration of each advertisement was recorded. Advertisements were classified as core (nutrient-rich/calorie-low products), non-core, or miscellaneous based on the international system, and either healthy/less healthy, i...
August 2016: Public Health
(no author information available yet)
The American Hospital Association (AHA) and other hospitals are suing CMS, challenging the 0.2% cut in Medicare reimbursement that CMS instituted to compensate for the financial effect of the Two-Midnight rule. CMS' actuaries reported that inpatient claims are likely to increase under the rule, resulting in $220 million additional reimbursement for hospitals. Hospitals disagree and a study commissioned by the AHA concluded that the CMS study was based on data not available to the public and that data from the Medicare Provider and Analysis Review (MedPAR) would lead to a different conclusion...
April 2016: Hospital Case Management: the Monthly Update on Hospital-based Care Planning and Critical Paths
(no author information available yet)
It's been more than two years since the Two-Midnight rule went into effect, but the Centers for Medicare & Medicaid Services' attempt to clear up confusion about patient status just has people more uncertain. Case managers should monitor patients at every access point in the hospital and work with the admitting physicians to ensure that patients are in the proper status. Observation patients should be easily identified, preferably in a dedicated observation unit, so clinicians know to give them priority and either admit or discharge them...
April 2016: Hospital Case Management: the Monthly Update on Hospital-based Care Planning and Critical Paths
Michael C Thomas, Nicole M Acquisto, Mary Beth Shirk, Asad E Patanwala
PURPOSE: The results of a survey to characterize pharmacy practice in emergency department (ED) settings are reported. METHODS: An electronic survey was sent to all members of the American Society of Health-System Pharmacists' Emergency Medicine Connect group and the American College of Clinical Pharmacy's Emergency Medicine Practice and Research Network. Approximately 400 nontrainee pharmacy practitioners were invited to participate in the survey, which was open for 30 days...
March 15, 2016: American Journal of Health-system Pharmacy: AJHP
Peter H Hinderling
Potassium is critical for maintaining cellular tonicity, propagation of nerve impulses, contraction of cardiac, skeletal, and smooth muscles, and normal renal function. The focus of this review is on the pharmacokinetics of potassium, K(+) , after administration of liquid and solid formulations of potassium chloride, KCl, to healthy subjects. Potassium can be considered an endogenous and exogenous compound. The amounts of endogenous K(+) are kept constant by balancing intake and loss of exogenous K(+) . Food and ingestion of KCl-containing medicines are sources for exogenous K(+) ...
October 2016: Journal of Clinical Pharmacology
Juan E Romano, Abdalhamid Alkar, Victor O Fuentes-Hernández, Marcel Amstalden
The objectives of the present study were to assess the effect of permanent contact of teasers without copulation on the interval from controlled internal drug release (CIDR) removal to estrus onset, estrus duration, ovulation time, number of ovulations, and interval from CIDR removal to ovulation time on estrus-synchronized Boer goats. During the fall season, a controlled randomized design experiment with two groups, control (CON; n = 18) and treatment (TRE; n = 18), was performed. The TRE group was maintained permanently in a pen with an aproned buck immediately after CIDR removal...
April 15, 2016: Theriogenology
Michael Robert Smith, Robert Lee Davis, Patricia Anne Phillips, Tatyana Shvilkina, Kamalijit Kaur, Heather Katrina Tabolt, Matthew Krause, Vincent Galdi
PREMISE: Although trauma may be considered a random act, geographical patterns of trauma potentially emerge. Our institution is unique in that it rests at an intersection of two of the highest areas of poverty and assault in New York City and has adequate data to analyze these patterns. METHODS: We review the incident reports logged by emergency medical services (EMS) technicians arriving with intentionally injured trauma patients from January 1 to December 31, 2013 at a single institution...
January 29, 2016: Annals of Surgery
(no author information available yet)
In the Outpatient Prospective Payment System final rule for 2016, the Centers for Medicare & Medicaid Services modified the two-midnight rule to allow shorter stays to be billed as inpatient stays based on the judgment of the admitting physician. CMS shifted enforcement of the rule to two Beneficiary and Family-Centered Care Quality Improvement Organizations, which will alert the Recovery Auditors if they find patterns of high rates of claims denials. CMS did not include any guidance about what constitutes a short stay except to say that it's a matter of physician judgment...
January 2016: Hospital Case Management: the Monthly Update on Hospital-based Care Planning and Critical Paths
A V Kasbekar, F Davies, N Upile, M W Ho, N J Roland
Introduction The management of vacuum neck drains in head and neck surgery is varied. We aimed to improve early drain removal and therefore patient discharge in a safe and effective manner. Methods The postoperative management of head and neck surgical patients with vacuum neck drains was reviewed retrospectively. A new policy was then implemented to measure drainage three times daily (midnight, 6am, midday). The decision for drain removal was based on the most recent drainage period (at <3ml per hour). A further patient cohort was subsequently assessed prospectively...
January 2016: Annals of the Royal College of Surgeons of England
Sara Giuliani, Alexa McArthur, John Greenwood
BACKGROUND: Major burn injury patients commonly fast preoperatively before multiple surgical procedures. The Societies of Anesthesiology in Europe and the United States recommend fasting from clear fluids for two hours and solids for six to eight hours preoperatively. However, at the Royal Adelaide Hospital, patients often fast from midnight proceeding the day of surgery. This project aims to promote evidence-based practice to minimize extended preoperative fasting in major burn patients...
November 2015: JBI Database of Systematic Reviews and Implementation Reports
Hyder Osman Mirghani, Osama Salih Mohammed, Yahia Mohamed Almurtadha, Moneir Siddig Ahmed
BACKGROUND: There is increasing awareness about the association of sleep quality and academic achievement among university students. However, the relationship between sleep quality and academic performance has not been examined in Sudan; this study assessed the relationship between sleep quality and academic performance among Sudanese medical students. METHODS: A case-control study was conducted among 165 male and female medical students at two Sudanese universities...
2015: BMC Research Notes
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