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https://www.readbyqxmd.com/read/29050058/-ambulant-anesthesia-limits-and-possibilities
#1
Harald Hofer, Frank Vescia
The number of operations carried out on an outpatient basis is increasing in Germany. This trend has been observed for years. The prerequisite is an infrastructure that is in line with guidelines. The competence of the anesthetist must not be restricted to that of a standard specialist anesthetist, but the physician should have experience in ambulatory anesthesia. Well-adjusted comorbidities of the patient are generally not a contraindication for an outpatient procedure. The heavily overweight patient can also be operated on an outpatient basis if he is compliant, comorbidities are well adjusted and intensive postoperative care is ensured...
October 2017: Anästhesiologie, Intensivmedizin, Notfallmedizin, Schmerztherapie: AINS
https://www.readbyqxmd.com/read/29045356/addressing-safe-opioid-monitoring-practices-using-an-interprofessional-approach
#2
Marianne L Durham, AnnMarie Egan, Ann Jankiewicz, Marcia P Murphy, Patricia Nedved, Renee Luvich, Ann Goh, Louis Fogg
OBJECTIVE: The aims of the project are to increase knowledge related to opioids and improve adherence to evidence-based interventions for sedation monitoring and assessment in adult inpatients receiving opioids for pain through delivery of an interprofessional online program. BACKGROUND: Preventable opioid-induced respiratory depression is a patient safety risk in hospitals. Sedation and respiratory assessment and monitoring guidelines and tools are available to improve practice...
October 17, 2017: Journal of Nursing Administration
https://www.readbyqxmd.com/read/29039305/changing-epidemiology-of-pneumocystis-pneumonia-northern-ireland-uk-and-implications-for-prevention-1-july-2011-31-july-2012
#3
Lynsey Patterson, Peter Coyle, Tanya Curran, Neville Q Verlander, Jillian Johnston
PURPOSE: There is a lack of consensus about which non-human immunodeficiency virus (HIV) patient groups would benefit from prophylaxis. Here, we analysed an enhanced Pneumocystis jirovecii database to describe the epidemiology of Pneumocystis pneumonia (PCP) and P. jirovecii colonizations in Northern Ireland (NI) with a view to identifying risk groups who may benefit from prophylaxis. METHODOLOGY: We prospectively collected information on demographics, clinical severity and clinical features for all hospital inpatients in NI aged ≥18 years with P...
October 17, 2017: Journal of Medical Microbiology
https://www.readbyqxmd.com/read/29039054/treatment-persistence-and-healthcare-costs-among-patients-with-rheumatoid-arthritis-changing-biologics-in-the-usa
#4
Benjamin Chastek, Chieh-I Chen, Clare Proudfoot, Shraddha Shinde, Andreas Kuznik, Wenhui Wei
INTRODUCTION: After a patient with rheumatoid arthritis (RA) fails tumor necrosis factor inhibitor (TNFi) treatment, clinical guidelines support either cycling to another TNFi or switching to a different mechanism of action (MOA), but payers often require TNFi cycling before they reimburse switching MOA. This study examined treatment persistence, cost, and cost per persistent patient among MOA switchers versus TNFi cyclers. METHODS: This study of Commercial and Medicare Advantage claims data from the Optum Research Database included patients with RA and at least one claim for a TNFi (adalimumab, certolizumab pegol, etanercept, golimumab, or infliximab) between January 2012 and September 2015 who changed to another TNFi or a different MOA therapy (abatacept, tocilizumab, or tofacitinib) within 1 year...
October 16, 2017: Advances in Therapy
https://www.readbyqxmd.com/read/29036007/trends-of-cholecystectomies-for-presumed-biliary-dyskinesia-in-children-in-the-united-states
#5
Sravan R Matta, Katja Kovacic, Ke Yan, Pippa Simpson, Manu R Sood
BACKGROUND: Biliary dyskinesia is a controversial clinical entity. Standardized diagnostic test and management guidelines are lacking in children. Published data suggest that long-term outcomes of surgical and medical management are similar. We sought to determine national population-based trends of cholecystectomies performed in children for biliary dyskinesia and associated healthcare expenditure in the US over a 10-year period. METHODS: Using Nationwide Inpatient Sample and the International Classification of Diseases, the 9th revision clinical modification codes, we identified children who had a cholecystectomy for biliary dyskinesia from 2002-2011 in the United States...
October 13, 2017: Journal of Pediatric Gastroenterology and Nutrition
https://www.readbyqxmd.com/read/29030806/palliative-care-in-the-management-of-patients-with-advanced-heart-failure
#6
Susan E Lowey
Globally, there are 18-million individuals living with heart failure, a disease that is responsible for 12-15 million office visits and 6.5 million inpatient hospitalizations each year. As HF becomes advanced or end-stage, patients often live in a cycle of frequent transitions between care settings, and with unmet needs, including distress from inadequately managed symptoms. Prognostication in patients with heart failure can be challenging due to the unpredictable exacerbating-remitting illness trajectory that is associated with this progressive disease...
October 14, 2017: Advances in Experimental Medicine and Biology
https://www.readbyqxmd.com/read/29027759/greek-physiotherapists-perspectives-on-rehabilitation-following-total-knee-replacement-a-descriptive-survey
#7
Maria Moutzouri, Nigel Gleeson, Evdokia Billis, Elias Tsepis, John Gliatis
BACKGROUND AND PURPOSE: In Greece, as in many countries, there is a scarcity of evidence in the type of physiotherapy services offered for the rehabilitation of total knee replacement (TKR). Despite the number of TKRs annually performed in Greece (over 10,000), there are no available clinical guidelines as to the content of best physiotherapy practice. The aim of this nationwide survey undertaken by physiotherapists treating TKR patients post-operatively was to record standard practice and services available in Greece...
October 2017: Physiotherapy Research International: the Journal for Researchers and Clinicians in Physical Therapy
https://www.readbyqxmd.com/read/29024540/infections-resistance-patterns-and-antibiotic-use-in-patients-at-a-regional-cancer-centre
#8
Nivanka De Silva, Justin Jackson, Christopher Steer
AIMS: To document patient characteristics, infection types, patterns of antibiotic resistance and outcomes in all patients with cancer requiring inpatient management for suspected infection at a regional Australian cancer centre. METHODS: We studied patients ≥ 18 years of age who were admitted under the oncology unit at Albury Wodonga Health during a 12-month period and who had a microbiological test performed for suspected infection during their admission...
October 11, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/29021359/increasing-prevalence-of-vascular-risk-factors-in-patients-with-stroke-a-call-to-action
#9
Fadar Oliver Otite, Nicholas Liaw, Priyank Khandelwal, Amer M Malik, Jose G Romano, Tatjana Rundek, Ralph L Sacco, Seemant Chaturvedi
OBJECTIVE: To evaluate trends in prevalence of cardiovascular risk factors (hypertension, diabetes, dyslipidemia, smoking, and drug abuse) and cardiovascular diseases (carotid stenosis, chronic renal failure [CRF], and coronary artery disease [CAD]) in acute ischemic stroke (AIS) in the United States. METHODS: We used the 2004-2014 National Inpatient Sample to compute weighted prevalence of each risk factor in hospitalized patients with AIS and used joinpoint regression to evaluate change in prevalence over time...
October 11, 2017: Neurology
https://www.readbyqxmd.com/read/29017389/the-canadian-laboratory-initiative-on-pediatric-reference-intervals-a-caliper-white-paper
#10
Khosrow Adeli, Victoria Higgins, Karin Trajcevski, Nicole White-Al Habeeb
Laboratory investigations provide physicians with objective data to aid in disease diagnosis, clinical decision making, and patient follow up. Clinical interpretation of laboratory test results relies heavily on the availability of appropriate population-based reference intervals (i.e. normative values) or decision limits developed through clinical outcome studies. Although reference intervals are fundamental to accurate laboratory test interpretation, and thus critically important to healthcare, the need for sound evidence-based reference intervals has been largely overlooked, particularly in the pediatric population...
October 11, 2017: Critical Reviews in Clinical Laboratory Sciences
https://www.readbyqxmd.com/read/29016692/benefit-of-early-discharge-among-patients-with-low-risk-pulmonary-embolism
#11
Li Wang, Onur Baser, Phil Wells, W Frank Peacock, Craig I Coleman, Gregory J Fermann, Jeff Schein, Concetta Crivera
Clinical guidelines recommend early discharge of patients with low-risk pulmonary embolism (LRPE). This study measured the overall impact of early discharge of LRPE patients on clinical outcomes and costs in the Veterans Health Administration population. Adult patients with ≥1 inpatient diagnosis for pulmonary embolism (PE) (index date) between 10/2011-06/2015, continuous enrollment for ≥12 months pre- and 3 months post-index date were included. PE risk stratification was performed using the simplified Pulmonary Embolism Stratification Index...
2017: PloS One
https://www.readbyqxmd.com/read/28990160/monitoring-of-potentially-inappropriate-prescriptions-in-older-inpatients-a-french-multicenter-study
#12
Irène Pandraud-Riguet, Dominique Bonnet-Zamponi, Elsa Bourcier, Marion Buyse, Sandra Laribe-Caget, Patrick Frémont, Eric Pautas, Christiane Verny, Patrick Hindlet, Christine Fernandez
OBJECTIVES: To determine whether potentially inappropriate medications (PIMs) or potentially inappropriate associations (PIAs) prescribed knowingly are associated with patient monitoring. DESIGN: Prospective observational study. SETTING: Geriatric units (n = 56) in 28 hospitals. PARTICIPANTS: Inpatients aged 75 and older (N = 1,327). MEASUREMENTS: Potentially inappropriate prescriptions (PIP) were defined as a PIM or a PIA selected by an expert board from lists of explicit criteria (Beers, Priscus, Laroche, French Health Agency) using a Delphi process...
October 9, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28987317/nationwide-survival-after-inhospital-cardiac-arrest-before-and-after-2010-cardiopulmonary-resuscitation-guidelines-2007-2014
#13
Sagar Mallikethi-Reddy, Emmanuel Akintoye, Melvyn Rubenfire, Alexandros Briasoulis, Cindy L Grines, Luis Afonso
BACKGROUND: American Heart Association has been revising the cardiopulmonary resuscitation (CPR) guidelines quinquennially. We sought to study the influence of 2010 CPR guidelines on nationwide survival after inhospital cardiac arrest. METHODS: Healthcare Utilization Project's National Inpatient Sample 20007-2014, was used to identify 799,741 adults aged ≥15years, who underwent inhospital CPR. We compared inhospital survival trends during period before (2007-2010) and after (2011-2014) American Heart Association 2010 CPR guidelines...
September 29, 2017: International Journal of Cardiology
https://www.readbyqxmd.com/read/28973290/spinal-fusion-for-pediatric-spondylolisthesis-national-trends-complications-and-short-term-outcomes
#14
Kavelin Rumalla, Chester K Yarbrough, Andrew J Pugely, Ian G Dorward
BACKGROUND: Current surgical management guidelines for pediatric spondylolisthesis (PS) are reliant on data from single-center cohorts. OBJECTIVE: To analyze national trends and predictors of short-term outcomes in spinal fusion surgery for PS by performing a retrospective cross-sectional analysis of the Kids' Inpatient Database (KID). METHODS: The KID (sampled every 3 yr) was queried from 2003 to 2012 to identify all cases (age 5-17) of spinal fusion for PS (n = 2646)...
July 7, 2017: Neurosurgery
https://www.readbyqxmd.com/read/28970405/retrospective-evaluation-of-pharmacist-interventions-on-use-of-antimicrobials-using-a-clinical-surveillance-software-in-a-small-community-hospital
#15
Samuel R Huber, Fekadu Fullas, Kristel R Nelson, Lesleigh B Ailts, James M Stratton, Michael T Padomek
The Infectious Diseases Society of America and the Society for Healthcare Epidemiology of America "Guidelines for Developing an Institutional Program to Enhance Antimicrobial Stewardship" recommend the use of computer-based surveillance programs for efficient and thorough identification of potential interventions as part of an antimicrobial stewardship program (ASP). This retrospective study examined the benefit of utilizing a clinical surveillance software program to help guide antimicrobial therapy in an inpatient setting, in a small community hospital, without a formal ASP...
October 21, 2016: Pharmacy (Basel, Switzerland)
https://www.readbyqxmd.com/read/28967164/negative-predictive-value-of-dobutamine-stress-echocardiography-for-perioperative-risk-stratification-in-patients-with-cardiac-risk-factors-and-reduced-exercise-capacity-undergoing-non-cardiac-surgery
#16
Gus Go, Kathy T Davies, Cara O'Callaghan, Wendy Senior, Karam Kostner, Narelle Fagermo, Sandhir B Prasad
BACKGROUND: Guidelines recommend functional testing for myocardial ischaemia in the perioperative setting in patients with >1 recognised cardiac risk factors and self-reported reduced exercise capacity. We sought to determine the clinical utility of dobutamine stress echocardiography (DSE) for perioperative risk stratification in patients undergoing major noncardiac surgery. METHODS: Data on 79 consecutive patients undergoing DSE for perioperative risk stratification at a single centre was retrospectively reviewed to determine rates of Major Adverse Cardiac Events (MACE) during the index hospitalisation and 30 days post discharge...
October 2, 2017: Internal Medicine Journal
https://www.readbyqxmd.com/read/28964433/cost-effectiveness-analysis-of-natriuretic-peptide-testing-and-specialist-management-in-patients-with-suspected-acute-heart-failure
#17
Edward A Griffin, David Wonderling, Andrew J Ludman, Abdallah Al-Mohammad, Martin R Cowie, Suzanna M C Hardman, John J V McMurray, Jason Kendall, Polly Mitchell, Aminat Shote, Katharina Dworzynski, Jonathan Mant
OBJECTIVES: To determine the cost-effectiveness of natriuretic peptide (NP) testing and specialist outreach in patients with acute heart failure (AHF) residing off the cardiology ward. METHODS: We used a Markov model to estimate costs and quality-adjusted life-years (QALYs) for patients presenting to hospital with suspected AHF. We examined diagnostic workup with and without the NP test in suspected new cases, and we examined the impact of specialist heart failure outreach in all suspected cases...
September 2017: Value in Health: the Journal of the International Society for Pharmacoeconomics and Outcomes Research
https://www.readbyqxmd.com/read/28960742/is-restraint-a-necessary-evil-in-mental-health-care-mental-health-inpatients-and-staff-members-experience-of-physical-restraint
#18
Ceri Wilson, Lorna Rouse, Sarah Rae, Manaan Kar Ray
Restraint in mental health care has negative consequences, and guidelines/policies calling for its reduction have emerged internationally. However, there is tension between reducing restraint and maintaining safety. In order to reduce restraint, it is important to gain an understanding of the experience for all involved. The aim of the present study was to improve understanding of the experience of restraint for patients and staff with direct experience and witnesses. Interviews were conducted with 13 patients and 22 staff members from one UK National Health Service trust...
October 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/28959497/the-american-heart-association-s-get-with-the-guidelines-gwtg-stroke-development-and-impact-on-stroke-care
#19
REVIEW
Cora H Ormseth, Kevin N Sheth, Jeffrey L Saver, Gregg C Fonarow, Lee H Schwamm
The American Heart Association's Get With the Guidelines (GWTG)-Stroke programme has changed stroke care delivery in the USA since its establishment in 2003. GWTG is a voluntary registry and continuous quality improvement initiative that collects data on patient characteristics, hospital adherence to guidelines and inpatient outcomes. Implementation of the programme saw increased provision of evidence-based care and improved patient outcomes. This review will describe the development of the programme and discuss the impact on stroke outcomes and transformation of stroke care delivery that followed its implementation...
June 2017: Stroke and Vascular Neurology
https://www.readbyqxmd.com/read/28958579/-needs-assessment-to-improve-the-applicability-and-methodological-quality-of-a-german-s3-guideline
#20
Marion Burckhardt, Cristina Hoffmann, Brigitte Nink-Grebe, Sylvia Sänger
BACKGROUND: Clinical practice guidelines can change the practice in healthcare only if their recommendations are implemented in a comprehensive way. The German S3 guideline "Local Therapy of Chronic Wounds in Patients with Peripheral Vascular Disease, Chronic Venous Insufficiency, and Diabetes" will be updated in 2017. The emphasis here is on the guideline's validity, user-friendliness and implementation into practice. Therefore, the aim was to identify the improvements required in regard to the guideline's methods and content presentation...
September 25, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
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