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https://www.readbyqxmd.com/read/28816756/characterizing-the-posttransfer-period-among-patients-with-pediatric-onset-ibd-the-impact-of-academic-versus-community-adult-care-on-emergent-health-resource-utilization
#1
Natasha Bollegala, Eric I Benchimol, Anne M Griffiths, Adrienne Kovacs, Allan H Steinhart, Xinbei Zhao, Geoffrey C Nguyen
BACKGROUND: Patients diagnosed with inflammatory bowel disease (IBD) during childhood require transfer to an adult gastroenterologist, in Ontario usually just before their 18th birthday. Pediatric onset IBD is a complex phenotype with demonstrated noncompliance risk that may require targeted measures to optimize health care outcomes in the adult care setting. PURPOSE: The purpose of this study was to determine the impact of posttransfer health care setting (academic versus community gastroenterologist) on emergent health resource utilization...
September 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28816746/characterizing-the-posttransfer-period-among-patients-with-pediatric-onset-ibd-the-impact-of-academic-versus-community-adult-care-on-emergent-health-resource-utilization
#2
Natasha Bollegala, Eric I Benchimol, Anne M Griffiths, Adrienne Kovacs, Allan H Steinhart, Xinbei Zhao, Geoffrey C Nguyen
BACKGROUND: Patients diagnosed with inflammatory bowel disease (IBD) during childhood require transfer to an adult gastroenterologist, in Ontario usually just before their 18th birthday. Pediatric onset IBD is a complex phenotype with demonstrated noncompliance risk that may require targeted measures to optimize health care outcomes in the adult care setting. PURPOSE: The purpose of this study was to determine the impact of posttransfer health care setting (academic versus community gastroenterologist) on emergent health resource utilization...
August 14, 2017: Inflammatory Bowel Diseases
https://www.readbyqxmd.com/read/28816338/prediction-of-emergency-department-hospital-admission-based-on-natural-language-processing-and-neural-networks
#3
Xingyu Zhang, Joyce Kim, Rachel E Patzer, Stephen R Pitts, Aaron Patzer, Justin D Schrager
OBJECTIVE: To describe and compare logistic regression and neural network modeling strategies to predict hospital admission or transfer following initial presentation to Emergency Department (ED) triage with and without the addition of natural language processing elements. METHODS: Using data from the National Hospital Ambulatory Medical Care Survey (NHAMCS), a cross-sectional probability sample of United States EDs from 2012 and 2013 survey years, we developed several predictive models with the outcome being admission to the hospital or transfer vs...
August 16, 2017: Methods of Information in Medicine
https://www.readbyqxmd.com/read/28815552/connect-home-transitional-care-of-skilled-nursing-facility-patients-and-their-caregivers
#4
Mark Toles, Cathleen Colón-Emeric, Mary D Naylor, Josephine Asafu-Adjei, Laura C Hanson
BACKGROUND: Older adults that transfer from skilled nursing facilities (SNF) to home have significant risk for poor outcomes. Transitional care of SNF patients (i.e., time-limited services to ensure coordination and continuity of care) is poorly understood. OBJECTIVE: To determine the feasibility and relevance of the Connect-Home transitional care intervention, and to compare preparedness for discharge between comparison and intervention dyads. DESIGN: A non-randomized, historically controlled design-enrolling dyads of SNF patients and their family caregivers...
August 16, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28815143/analyzing-electronic-medical-records-to-predict-risk-of-dit-death-intubation-or-transfer-to-icu-in-pediatric-respiratory-failure-or-related-conditions
#5
Teeradache Viangteeravat, Oguz Akbilgic, Robert Lowell Davis
Large volumes of data are generated in hospital settings, including clinical and physiological data generated during the course of patient care. Our goal, as proof of concept, was to identify early clinical factors or traits useful for predicting the outcome, of death, intubation, or transfer to ICU, for children with pediatric respiratory failure. We implemented both supervised and unsupervised methods to extend our understanding on statistical relationships in clinical and physiological data. As a supervised learning method, we use binary logistic regression to predict the risk of developing DIT outcome...
2017: AMIA Summits on Translational Science Proceedings
https://www.readbyqxmd.com/read/28814284/effect-of-poly-hexamethylene-biguanide-hydrochloride-phmb-treated-non-sterile-medical-gloves-upon-the-transmission-of-streptococcus-pyogenes-carbapenem-resistant-e-coli-mrsa-and-klebsiella-pneumoniae-from-contact-surfaces
#6
S Ali, A P R Wilson
BACKGROUND: Reduction of accidental contamination of the near-patient environment has potential to reduce acquisition of healthcare-associated infection(s). Although medical gloves should be removed when soiled or touching the environment, compliance is variable. The use of antimicrobial-impregnated medical gloves could reduce the horizontal-transfer of bacterial contamination between surfaces. AIM: Determine the activity of antimicrobial-impregnated gloves against common hospital pathogens: Streptococcus pyogenes, carbapenem-resistant E...
August 17, 2017: BMC Infectious Diseases
https://www.readbyqxmd.com/read/28813751/superior-ophthalmic-vein-thrombosis-the-role-of-anticoagulation
#7
Samuel Thomsen, Eric Larson, Michael Greenwood
PURPOSE: To report a case of superior ophthalmic vein thrombosis (SOVT) and review the available literature to assess if anticoagulation is warranted in all cases of SOVT. OBSERVATIONS: The patient presented to an outside hospital facility with a severe headache involving the left frontal temporal area. This progressed to left-sided ptosis and facial droop. Magnetic resonance imaging revealed a left SOVT secondary to sphenoid sinusitis. Treatment was initiated with vancomycin and cefepime, and the patient was transferred to our tertiary care center for further management...
May 2017: South Dakota Medicine: the Journal of the South Dakota State Medical Association
https://www.readbyqxmd.com/read/28811944/successful-resuscitation-of-a-patient-with-life-threatening-metabolic-acidosis-by-hemodialysis-a-case-of-ethylene-glycol-intoxication
#8
Ikuyo Narita, Michiko Shimada, Norio Nakamura, Reiichi Murakami, Takeshi Fujita, Wakako Fukuda, Hirofumi Tomita
BACKGROUND: Ethylene glycol intoxication causes severe metabolic acidosis and acute kidney injury. Fomepizole has become available as its antidote. Nevertheless, a prompt diagnosis is not easy because patients are often unconscious. Here we present a case of ethylene glycol intoxication who successfully recovered with prompt hemodialysis. CASE PRESENTATION: A 52-year-old Japanese male was admitted to a local hospital due to suspected food poisoning. The patient presented with nausea and vomiting, but his condition rapidly deteriorated, with worsening conscious level, respiratory distress requiring mechanical ventilation, hypotension, and severe acute kidney injury...
2017: Case Reports in Nephrology
https://www.readbyqxmd.com/read/28810959/a-retrospective-review-of-clinical-admissions-to-afghan-national-security-forces-health-care-institutions
#9
Christian W Ertl, David Royal, Jairo Espinosa
BACKGROUND: Few published reports have examined the numbers of civilian injuries treated at Military Treatment Facilities in the Afghan Theater of Operations. However, review of Department of Defense Trauma Registry revealed a persistent percentage of civilians treated by NATO, and this study compares the proportion of civilians served by Afghan and Coalition military hospitals between 2009 and 2013. METHODS: A retrospective review of records from Department of Defense trauma Registry for Coalition data, and Afghan data from the Office of the Inspector General...
July 2017: Military Medicine
https://www.readbyqxmd.com/read/28810897/cost-of-hospitalization-for-childbirth-in-india-how-equitable-it-is-in-the-post-nrhm-era
#10
Jaya Prasad Tripathy, Hemant D Shewade, Sanskruti Mishra, A M V Kumar, A D Harries
BACKGROUND AND OBJECTIVE: Information on out-of-pocket (OOP) expenditure during childbirth in public and private health facilities in India is needed to make rational decisions for improving affordability to maternal care services. We undertook this study to evaluate the OOP expenditure due to hospitalization from childbirth and its impact on households. METHODS: This is a secondary data analysis of a nationwide household survey by the National Sample Survey Organization in 2014...
August 15, 2017: BMC Research Notes
https://www.readbyqxmd.com/read/28810888/hospitalisation-in-an-emergency-department-short-stay-unit-compared-to-an-internal-medicine-department-is-associated-with-fewer-complications-in-older-patients-an-observational-study
#11
Camilla Strøm, Talie Khadem Mollerup, Laurits Schou Kromberg, Lars Simon Rasmussen, Thomas Andersen Schmidt
BACKGROUND: Older patients are at particular risk of experiencing adverse events during hospitalisation. OBJECTIVE: To compare the frequencies and types of adverse events during hospitalisation in older persons acutely admitted to either an Emergency Department Short-stay Unit (SSU) or an Internal Medicine Department (IMD). METHODS: Observational study evaluating adverse events during hospitalisation in non-emergent, age-matched, internal medicine patients ≥75 years, acutely admitted to either the SSU or the IMD at Holbaek Hospital, Denmark, from January to August, 2014...
August 15, 2017: Scandinavian Journal of Trauma, Resuscitation and Emergency Medicine
https://www.readbyqxmd.com/read/28809180/exploring-socio-technical-insights-for-safe-nursing-handover
#12
Ming Chao Wong, Kwang Chien Yee, Paul Turner
Current efforts to improve nursing handover frequently use prescriptive approaches based on research evidence of handover issues within a single nursing ward or nursing specialty. Despite reported handover improvement, few studies adequately consider the transferability of results to other nursing handover environments or acknowledge the unique attributes that supported sustained improvement. With the increasing diffusion of electronic tools it has become even more critical to ensure that socio-technical issues that may impact on the quality and safety of nursing handovers are identified...
2017: Studies in Health Technology and Informatics
https://www.readbyqxmd.com/read/28807482/postoperative-complications-after-head-and-neck-operations-that-require-free-tissue-transfer-prevalence-morbidity-and-cost
#13
J McMahon, T P B Handley, A Bobinskas, M Elsapagh, H S Anwar, P V Ricciardo, A McLaren, R Davis, N Syyed, C MacIver, C Wales, W S Hislop, E Thomson, S Thomson, K Fitzpatrick, A Rae, R Campbell
To understand and reduce the impact of postoperative complications, we studied 568 patients who had had operations over 72 months in our hospital. Multivariate analysis indicated that factors indicative of coexisting conditions (including activated systemic inflammation) and the complexity of the operation are primary determinants of postoperative complications. The enhanced recovery after surgery (ERAS) care pathway did not have an effect on their occurrence or severity. Systematic study of patients' toleration of major head and neck operations is required, as optimal perioperative care pathways remain elusive...
August 11, 2017: British Journal of Oral & Maxillofacial Surgery
https://www.readbyqxmd.com/read/28807208/imaging-for-acute-appendicitis-at-nonpediatric-centers-exposes-children-to-excess-radiation
#14
Faidah Badru, Nicholas Piening, Alvin To, Perry Xu, Colleen Fitzpatrick, Kaveer Chatoorgoon, Gustavo Villalona, Jose Greenspon
BACKGROUND: Radiation exposure is the reason for the decreased utilization of computed tomography (CT) in pediatric centers (PCs). We sought to compare the radiation dose exposure of CT imaging performed at outside hospitals (OH) versus PC in pediatric patients with acute appendicitis (AA). MATERIAL AND METHODS: A retrospective review of all patients managed at our PC for AA from January 2011 to March 2016 was performed. Patients who had CT imaging for AA at OH were compared to those who underwent CT for appendicitis at our PC...
August 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/28805950/management-of-osteonecrosis-of-the-femoral-head-with-pedicled-iliac-bone-flap-transfer-a-multicenter-study-of-2190-patients
#15
Dewei Zhao, Hui Xie, Yongqing Xu, Yisheng Wang, Aixi Yu, Youwen Liu, Aimin Wang, Wei He, Xiuli Wang, Zirong Li, Wei Sun, Simiao Tian, Benjie Wang, Baoyi Liu
BACKGROUND: Osteonecrosis of the femoral head (ONFH) often affects young active adults and leads to destruction of the hip joint and disabling arthritis. Several procedures have been developed to arrest the progress of osteonecrosis and postpone the procedure of total hip replacement especially in young patients. The aim of this multicenter study was to analyze the results of the use of the vascularized iliac bone flap transfer for management of ONFH. METHODS: From January 1985 to December 2012, a total of 2190 patients (2690 hips) with the mean age of 43...
August 14, 2017: Microsurgery
https://www.readbyqxmd.com/read/28803549/comparative-gut-microbiota-and-resistome-profiling-of-intensive-care-patients-receiving-selective-digestive-tract-decontamination-and-healthy-subjects
#16
Elena Buelow, Teresita D J Bello González, Susana Fuentes, Wouter A A de Steenhuijsen Piters, Leo Lahti, Jumamurat R Bayjanov, Eline A M Majoor, Johanna C Braat, Maaike S M van Mourik, Evelien A N Oostdijk, Rob J L Willems, Marc J M Bonten, Mark W J van Passel, Hauke Smidt, Willem van Schaik
BACKGROUND: The gut microbiota is a reservoir of opportunistic pathogens that can cause life-threatening infections in critically ill patients during their stay in an intensive care unit (ICU). To suppress gut colonization with opportunistic pathogens, a prophylactic antibiotic regimen, termed "selective decontamination of the digestive tract" (SDD), is used in some countries where it improves clinical outcome in ICU patients. Yet, the impact of ICU hospitalization and SDD on the gut microbiota remains largely unknown...
August 14, 2017: Microbiome
https://www.readbyqxmd.com/read/28802997/prophylactic-use-of-an-intra-aortic-balloon-pump-in-a-high-risk-patient-with-peripartum-cardiomyopathy-requiring-cesarean-delivery
#17
R S Samalavicius, L Puodziukaite, I Radaviciute, I Norkiene, K Urbonas, I Misiuriene, V Janusauskas, A Zorinas, K Rucinskas, P Serpytis
The use of intra-aortic balloon counter-pulsation for circulatory support in pregnant women with cardiac failure is limited to several case reports. Few publications have addressed the use of intra-aortic balloon counter-pulsation during delivery. We report a case using prophylactic intra-aortic counter-pulsation during the management of a cesarean delivery in a patient with peripartum cardiomyopathy. A 28-year-old primigravid female at 37weeks of gestation was admitted with signs of worsening heart failure, and transthoracic echocardiography revealed a decreased left ventricular ejection fraction of 25%...
July 14, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28802837/development-of-simulation-optimization-methods-for-solving-patient-referral-problems-in-the-hospital-collaboration-environment
#18
Ping-Shun Chen, Ming-Han Lin
This research studied a patient referral problem among multiple cooperative hospitals for sharing imaging services' referrals. The proposed problem consisted of many types of patients and the uncertainty associated with the number of patients of each type, patients' arrival time, and patients' medical operation time, leading to a difficulty in finding solutions due to the uncertain environment. This research used system simulation to construct a model and develop a simulation optimization method, combining the heuristic algorithm (patient referral mechanism) with the particle swarm optimization (PSO) method, to determine a better way to refer patients from one hospital (referring hospital) to another (recipient hospital) to receive certain imaging services...
August 9, 2017: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/28802421/symptomatic-medial-humeral-epicondylar-fracture-non-union-rare-presentation-of-a-relatively-common-injury
#19
Vidisha S Kulkarni, Nitish Arora, Harshit Gehlot, Sagar Saxena, Sunil G Kulkarni, Supreet Bajwa
BACKGROUND: Symptomatic non-union of medial humeral epicondylar fractures is a limited entity. Some studies recommend surgical excision of the fragment, but the results are controversial. The purpose of this study is to evaluate the outcome of open reduction and internal fixation of a medial epicondyle non-union fragment. MATERIALS AND METHODS: A retrospective study was conducted in all the patients, who were operated in our hospital between the year 2010 and 2015 for symptomatic medial humeral epicondyle non-union...
August 2017: Injury
https://www.readbyqxmd.com/read/28801413/effectiveness-of-rehabilitation-after-a-total-hip-arthroplasty-a-protocol-for-an-observational-study-for-the-comparison-of-usual-care-in-the-netherlands-versus-germany
#20
Gesine H Seeber, Annet Wijnen, Djordje Lazovic, Sjoerd K Bulstra, Günter Dietz, Christiaan P van Lingen, Martin Stevens
INTRODUCTION: Osteoarthritis is the most common joint disorder worldwide. Total hip arthroplasty (THA) is considered one of the most effective treatments for end-stage hip osteoarthritis. The number of THAs is expected to increase dramatically in the coming decades. Usual postoperative rehabilitation after primary THA differs between the German and the Dutch system. In the Netherlands, patients undergo fast-track surgery and are discharged into their home environment within a few days without receiving any aftercare...
August 11, 2017: BMJ Open
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