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https://www.readbyqxmd.com/read/28538964/effect-of-a-modified-hospital-elder-life-program-on-delirium-and-length-of-hospital-stay-in-patients-undergoing-abdominal-surgery-a-cluster-randomized-clinical-trial
#1
Cheryl Chia-Hui Chen, Hsiu-Ching Li, Jin-Tung Liang, I-Rue Lai, Jerry Dwi Trijoyo Purnomo, Yi-Ting Yang, Been-Ren Lin, John Huang, Ching-Yao Yang, Yu-Wen Tien, Chiung-Nien Chen, Ming-Tsan Lin, Guan-Hua Huang, Sharon K Inouye
Importance: Older patients undergoing abdominal surgery commonly experience preventable delirium, which extends their hospital length of stay (LOS). Objective: To examine whether a modified Hospital Elder Life Program (mHELP) reduces incident delirium and LOS in older patients undergoing abdominal surgery. Design, Setting, and Participants: This cluster randomized clinical trial of 577 eligible patients enrolled 377 older patients (≥65 years of age) undergoing gastrectomy, pancreaticoduodenectomy, and colectomy at a 2000-bed urban medical center in Taipei, Taiwan, from August 1, 2009, through October 31, 2012...
May 24, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28538781/effects-that-passive-cycling-exercise-have-on-muscle-strength-duration-of-mechanical-ventilation-and-length-of-hospital-stay-in-critically-ill-patients-a-randomized-clinical-trial
#2
Aline Dos Santos Machado, Ruy Camargo Pires-Neto, Maurício Tatsch Ximenes Carvalho, Janice Cristina Soares, Dannuey Machado Cardoso, Isabella Martins de Albuquerque
Objective: To evaluate the effects that passive cycling exercise, in combination with conventional physical therapy, have on peripheral muscle strength, duration of mechanical ventilation, and length of hospital stay in critically ill patients admitted to the ICU of a tertiary care university hospital. Methods: This was a randomized clinical trial involving 38 patients (≥ 18 years of age) on mechanical ventilation who were randomly divided into two groups: control (n = 16), receiving conventional physical therapy; and intervention (n = 22), receiving conventional physical therapy and engaging in passive cycling exercise five days per week...
March 2017: Jornal Brasileiro de Pneumologia: Publicaça̋o Oficial da Sociedade Brasileira de Pneumologia e Tisilogia
https://www.readbyqxmd.com/read/28538534/enhanced-recovery-after-surgery-for-hip-and-knee-replacements
#3
David P Gwynne-Jones, Ginny Martin, Chris Crane
BACKGROUND: Enhanced recovery after surgery (ERAS) programs or hip and knee replacements have had a significant effect on streamlining patient care with shorter stays, no increase in complications, and improved outcomes including reduced mortality. PURPOSE: To compare outcomes following the introduction of an ERAS program for hip and knee replacements developed at our institution with a historical cohort of patients. METHODS: ERAS protocols were developed at our institution for patients undergoing hip and knee joint replacements...
May 2017: Orthopaedic Nursing
https://www.readbyqxmd.com/read/28538140/comparison-of-policies-for-recognising-and-responding-to-clinical-deterioration-across-five-victorian-health-services
#4
Julie Considine, Anastasia F Hutchison, Helen Rawson, Alison M Hutchinson, Tracey Bucknall, Trisha Dunning, Mari Botti, Maxine M Duke, Maryann Street
Objectives The aim of the present study was to describe and compare organisational guidance documents related to recognising and responding to clinical deterioration across five health services in Victoria, Australia.Methods Guidance documents were obtained from five health services, comprising 13 acute care hospitals, eight subacute care hospitals and approximately 5500 beds. Analysis was guided by a specific policy analysis framework and a priori themes.Results In all, 22 guidance documents and five graphic observation and response charts were reviewed...
May 25, 2017: Australian Health Review: a Publication of the Australian Hospital Association
https://www.readbyqxmd.com/read/28535399/dry-skin-and-pressure-ulcer-risk-a-multi-center-cross-sectional-prevalence-study-in-german-hospitals-and-nursing-homes
#5
Anna Lechner, Nils Lahmann, Konrad Neumann, Ulrike Blume-Peytavi, Jan Kottner
BACKGROUND: Pressure ulcers are a serious health problem in medical and nursing care. Therefore, effective prevention is crucial. Major pressure ulcer risk factors have been identified but the particular role of dry skin (xerosis cutis) is unclear. OBJECTIVES: To investigate possible associations between dry skin and pressure ulcers focusing on the sacrum/trochanter and at heel/ankle skin areas. DESIGN: Two multicenter cross-sectional studies...
May 18, 2017: International Journal of Nursing Studies
https://www.readbyqxmd.com/read/28535331/computer-and-mobile-technology-interventions-for-self-management-in-chronic-obstructive-pulmonary-disease
#6
REVIEW
Catherine McCabe, Margaret McCann, Anne Marie Brady
BACKGROUND: Chronic obstructive pulmonary disease (COPD) is characterised by airflow obstruction due to an abnormal inflammatory response of the lungs to noxious particles or gases, for example, cigarette smoke. The pattern of care for people with moderate to very severe COPD often involves regular lengthy hospital admissions, which result in high healthcare costs and an undesirable effect on quality of life. Research over the past decade has focused on innovative methods for developing enabling and assistive technologies that facilitate patient self-management...
May 23, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28534128/cathepsin-l-activity-correlates-with-proteinuria-in-chronic-kidney-disease-in-humans
#7
Yu Cao, Xing Liu, Ying Li, Yao Lu, Hua Zhong, Weihong Jiang, Alex F Chen, Timothy R Billiar, Hong Yuan, Jingjing Cai
BACKGROUND: The presence and severity of proteinuria is considered an important prognostic marker in patients with chronic kidney disease (CKD) and is associated with mortality and morbidity. Cathepsin L is highly expressed in the foot processes of podocytes in the kidney, which serves as an ultrafiltration barrier. Cathepsin L is also up-regulated in the setting of inflammation as a feature of CKD. Therefore, we postulated that proteinuria severity in CKD patients might correlate with increased serum levels of cathepsin L...
May 22, 2017: International Urology and Nephrology
https://www.readbyqxmd.com/read/28533851/-giant-cell-tumors-of-the-tendon-sheaths-of-the-hand-about-50-cases
#8
Walid Osman, Zeineb Alaya, Ali Haggui, Mohamed Ben Rejeb, Sonia Jemni, Nader Naouar, Mohamed Laziz Ben Ayeche
Giant cell tumors of the synovial tendon sheaths (GCTSTS) are a localized form of hemopigmented villonodular synovitis. They mainly affect the hands. This study aims to analyse the epidemiology, clinical and therapeutic characteristics of GCTSTS, to assess the results of surgical treatment and to identify risk factors for recurrences. We conducted a retrospective data collection from medical records of 50 patients with GCTSTS of the hand between 1992 and 2016 in the Department of Orthopaedics at the Hospital of Sahloul (Sousse-Tunisia)...
2017: Pan African Medical Journal
https://www.readbyqxmd.com/read/28533106/trans-sectoral-care-of-geriatric-cancer-patients-based-on-comprehensive-geriatric-assessment-and-patient-reported-quality-of-life-results-of-a-multicenter-study-to-develop-and-pilot-test-a-patient-centered-interdisciplinary-care-concept-for-geriatric-oncology
#9
Heike Schmidt, Stephanie Boese, Katharina Lampe, Karin Jordan, Eckhard Fiedler, Ursula Müller-Werdan, Andreas Wienke, Dirk Vordermark
OBJECTIVES: For older patients with cancer the maintenance of independence, functionality and health-related quality of life (HRQOL) is of great importance. Aiming to maintain HRQOL of older patients with cancer we developed an interdisciplinary care program based on comprehensive geriatric assessment (CGA) and patient-reported HRQOL comprising tailored supportive measures and telephone-based counseling during 6month aftercare. MATERIALS AND METHODS: Pilot-testing of the intervention took place in three centers at the University Hospital Halle to examine feasibility, acceptance and potential benefit...
May 19, 2017: Journal of Geriatric Oncology
https://www.readbyqxmd.com/read/28532200/spinal-analgesia-improves-surgical-outcome-after-open-nephrectomy-for-renal-cell-carcinoma-a-randomized-controlled-study
#10
Mascha Thurm, Britt-Inger Kröger Dahlin, Ola Winsö, Börje Ljungberg
OBJECTIVE: This study evaluated whether more effective perioperative analgesia can be part of a multimodal approach to minimizing morbidity and improving postoperative management after the open surgical approaches frequently used in the treatment of renal cell carcinoma (RCC). The aim of the study was to determine whether spinal anesthesia with clonidine can enhance postoperative analgesia, speed up mobilization and reduce the length of hospital stay (LOS). MATERIALS AND METHODS: Between 2012 and 2015, 135 patients with RCC were randomized, in addition to general anesthesia, to receive either spinal analgesia with clonidine or epidural analgesia, stratified to surgical technique...
May 22, 2017: Scandinavian Journal of Urology
https://www.readbyqxmd.com/read/28531569/factors-associated-with-the-level-of-oral-intake-in-hospitalized-older-adults-with-dysphagia-the-importance-of-mental-activity
#11
Yoshitoshi Kuroda
BACKGROUND AND AIMS: Dysphagia is a highly prevalent condition in hospitalized older adults. One major consequence of dysphagia is reduced oral intake due to difficulty in safe and/or efficient swallowing. The aim of the present study was to explore the factors associated with the level of oral intake in older adults with dysphagia. METHODS: The subjects were enrolled from older patients admitted to an acute hospital presenting with dysphagia, consisting of 36 patients (16 men and 20 women) with a mean age of 88...
June 2016: Clinical Nutrition ESPEN
https://www.readbyqxmd.com/read/28530779/predictive-factors-for-early-hospital-readmission-and-1-year-mortality-in-elder-patients-following-surgical-treatment-of-a-hip-fracture
#12
Hakan Sofu, Hanifi Üçpunar, Yalkın Çamurcu, Serda Duman, Mehmet Nuri Konya, Sarper Gürsu, Vedat Şahin
BACKGROUND: Early hospital readmission after surgically treated hip fracture is a common entity, often involving an adverse event and causing strains on an already overburdened healthcare system. The main purposes of the present study were to determine the 30-day readmission rate, analyze the predictive factors for early hospital readmissions, and assess 1-year mortality following surgical treatment of hip fracture in elderly patients. Retrospective case-control study. METHODS: In total, 517 patients with a mean age of 74 years were evaluated...
May 2017: Ulusal Travma Ve Acil Cerrahi Dergisi, Turkish Journal of Trauma & Emergency Surgery: TJTES
https://www.readbyqxmd.com/read/28529729/characterization-of-the-novel-in1059-harbouring-vim-gene-cassette
#13
Dongguo Wang, Jinhong Yang, Meiyu Fang, Wei He, Ying Zhang, Caixia Liu, Dongsheng Zhou
BACKGROUND: VIM-type enzyme encodes the most widely acquired metallo-β-lactamases in Gram- negative bacteria. To obtain current epidemiological data for integrons from enterobacteriae in hospital, the study characterizes the genetic structure in In1059 by comparison with In846 integrons harbouring VIM gene and other class 1 integrons including In37, In62, In843 and In1021 with the aim of identifying the putative mechanisms involved integron mobilization and infer evolution of relevant integrons...
2017: Antimicrobial Resistance and Infection Control
https://www.readbyqxmd.com/read/28529195/rapid-web-based-platform-for-assessment-of-orthopedic-surgery-patient-care-milestones-a-2-year-validation
#14
Kenneth R Gundle, Dayne T Mickelson, Arien Cherones, Jason Black, Doug P Hanel
OBJECTIVE: To determine the validity, feasibility, and responsiveness of a new web-based platform for rapid milestone-based evaluations of orthopedic surgery residents. SETTING: Single academic medical center, including a trauma center and pediatrics tertiary hospital. PARTICIPANTS: Forty residents (PG1-5) in an orthopedic residency program and their faculty evaluators. METHODS: Residents and faculty were trained and supported in the use of a novel trainee-initiated web-based evaluation system...
May 18, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28528210/do-patients-need-to-stay-in-bed-all-day-in-the-epilepsy-monitoring-unit-safety-data-from-a-non-restrictive-setting
#15
Laura Craciun, Jørgen Alving, Elena Gardella, Daniella Terney, Pirgit Meritam, Melita Cacic Hribljan, Sándor Beniczky
PURPOSE: To assess whether injuries occur more often in an Epilepsy Monitoring Unit (EMU) where portable EEG amplifiers are used, and where patients can freely move within a large area during the monitoring. METHODS: Patients were monitored at the Danish Epilepsy Center, in an EMU specifically designed for this purpose, and they were under continuous surveillance by personnel dedicated to the EMU. Adverse events (AEs) - including injuries, were prospectively noted, as part of the safety policy of the hospital...
May 13, 2017: Seizure: the Journal of the British Epilepsy Association
https://www.readbyqxmd.com/read/28527287/-identification-of-the-mycobacterium-tuberculosis-beijing-lineage-in-ecuador
#16
Patricia Jiménez, Karina Calvopiña, Diana Herrera, Carlos Rojas, Laura Pérez-Lago, Marcelo Grijalva, Remedios Guna, Darío García-de Viedma
INTRODUCTION: Mycobacterium tuberculosis Beijing lineage isolates are considered to be especially virulent, transmissible and prone to acquire resistances. Beijing strains have been reported worldwide, but studies in Latin America are still scarce. The only multinational study performed in the region indicated a heterogeneous distribution for this lineage, which was absent in Chile, Colombia and Ecuador, although further studies found the lineage in Chile and Colombia. OBJECTIVE: To search for the presence of the Beijing lineage in Ecuador, the only country in the region where it remains unreported...
June 1, 2017: Biomédica: Revista del Instituto Nacional de Salud
https://www.readbyqxmd.com/read/28527227/correlation-of-the-gait-speed-with-the-quality-of-life-and-the-quality-of-life-classified-according-to-speed-based-community-ambulation-in-thai-stroke-survivors
#17
Phichamon Khanittanuphong, Suttipong Tipchatyotin
BACKGROUND: Gait abnormality commonly resulted from stroke which affected patients living and probably quality of life (QOL). OBJECTIVE: To assess the relationship between gait speed and the QOL in Thai stroke patients and to compare the QOL among three patient groups that were categorized by gait speed: i) household ambulators <0.4 m/s, ii) limited community ambulators 0.4-0.8 m/s and iii) community ambulators >0.8 m/s. METHODS: This was a cross-sectional descriptive research study...
May 19, 2017: NeuroRehabilitation
https://www.readbyqxmd.com/read/28526668/north-american-public-opinion-survey-on-the-acceptability-of-crowdsourcing-basic-life-support-for-out-of-hospital-cardiac-arrest-with-the-pulsepoint-mobile-phone-app
#18
Katie N Dainty, Haris Vaid, Steven C Brooks
BACKGROUND: The PulsePoint Respond app is a novel system that can be implemented in emergency dispatch centers to crowdsource basic life support (BLS) for patients with cardiac arrest and facilitate bystander cardiopulmonary resuscitation (CPR) and automated external defibrillator use while first responders are en route. OBJECTIVE: The aim of this study was to conduct a North American survey to evaluate the public perception of the above-mentioned strategy, including acceptability and willingness to respond to alerts...
May 17, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28526312/identification-of-low-high-and-super-gelers-and-barriers-to-hand-hygiene-among-intensive-care-unit-nurses
#19
Sharon Lea Kurtz
BACKGROUND: The purpose of this article was to provide information identified during hand hygiene (HH) surveillance periods at 5 intensive care units (ICUs) (4 hospitals) in Texas. METHODS: Using room entry and room exit, overt observation periods were 8 consecutive hours for 3-5 days on 64 ICU nurses. RESULTS: A total of 3,620 HH opportunities were recorded during 18 days of observation (144 hours). The average hand hygiene compliance (HHC) rate was 64%, with 19% of the nurses participating in HH in the 60%-69% range...
May 16, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28521829/supervised-injection-facilities-in-canada-past-present-and-future
#20
REVIEW
Thomas Kerr, Sanjana Mitra, Mary Clare Kennedy, Ryan McNeil
Canada has long contended with harms arising from injection drug use. In response to epidemics of HIV infection and overdose in Vancouver in the mid-1990s, a range of actors advocated for the creation of supervised injection facilities (SIFs), and after several unsanctioned SIFs operated briefly and closed, Canada's first sanctioned SIF opened in 2003. However, while a large body of evidence highlights the successes of this SIF in reducing the health and social harms associated with injection drug use, extraordinary efforts were needed to preserve it, and continued activism by local people who inject drugs (PWID) and healthcare providers was needed to promote further innovation and address gaps in SIF service delivery...
May 18, 2017: Harm Reduction Journal
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