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https://www.readbyqxmd.com/read/29236099/inpatient-management-of-diabetic-foot-infections-a-review-of-the-guidelines-for-hospitalists
#1
Emilia G Thurber, Flora Kisuule, Casey Humbyrd, Jennifer Townsend
Diabetic foot infections (DFIs) are common and represent the leading cause for hospitalization among diabetic complications. Without proper management, DFIs may lead to amputation, which is associated with a decreased quality of life and increased mortality. However, there is currently significant variation in the management of DFIs, and many providers fail to perform critical prevention and assessment measures. In this review, we will provide an overview of the diagnosis, management, and discharge planning of hospitalized patients with DFIs to guide hospitalists in the optimal inpatient care of patients with this condition...
December 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/29235661/association-of-higher-daptomycin-dose-%C3%A2-7-mg-kg-with-improved-survival-in-patients-with-methicillin-resistant-staphylococcus-aureus-bacteremia
#2
Tristan T Timbrook, Aisling R Caffrey, Megan K Luther, Vrishali Lopes, Kerry L LaPlante
STUDY OBJECTIVE: Current guidelines recommend higher daptomycin doses than the daptomycin label dose of 6 mg/kg for methicillin-resistant Staphylococcus aureus (MRSA) bacteremia; however, the evidence supporting this recommendation is from in vitro and cases series studies. The objective of this study was to evaluate the comparative effectiveness of the daptomycin label dose versus higher daptomycin doses in patients with MRSA bacteremia. DESIGN: Retrospective national cohort study...
December 13, 2017: Pharmacotherapy
https://www.readbyqxmd.com/read/29234842/-patients-with-a-wearable-cardioverter-defibrillator-wcd-prescription-function-and-rehabilitation-support
#3
REVIEW
A Schlitt, M Guha, M Noutsias, H H Klein, H U Klein
Assessment of a permanent risk of life-threatening ventricular arrhythmia in patients with severely reduced left ventricular ejection fraction (LVEF <35%), e. g. after myocarditis, dilated cardiomyopathy, acute myocardial infarction, in patients with postpartum cardiomyopathy or implantable cardioverter-defibrillator (ICD) and cardiac resynchronization treatment plus defibrillator (CRT-D) infection with temporary explantation of the system is a medical challenge. This is time-consuming and unsafe because life-threatening ventricular arrhythmias may occur during the time of risk assessment...
December 12, 2017: Herz
https://www.readbyqxmd.com/read/29232307/outcome-measure-scores-predict-discharge-destination-in-patients-with-acute-and-subacute-stroke-a-systematic-review-and-series-of-meta-analyses
#4
Emily R Thorpe, Katie B Garrett, Ashley M Smith, Jennifer C Reneker, Robert S Phillips
BACKGROUND AND PURPOSE: To identify the association between outcome measure score and discharge destination in adults following acute or subacute stroke in the United States. METHODS: A systematic literature search was performed in 3 databases using the PRISMA guidelines. Cohort studies were selected that included patients with acute or subacute stroke, which explored the relationship between scores on outcome measures and discharge destination. Four meta-analyses were performed...
January 2018: Journal of Neurologic Physical Therapy: JNPT
https://www.readbyqxmd.com/read/29230124/oncology-and-palliative-medicine-providing-comprehensive-care-for-patients-with-cancer
#5
REVIEW
Laura Finn, Alva Roche Green, Sonia Malhotra
Background: Despite the evidence for the fundamental need for palliative medicine services in the practice of oncology, integration of these medical specialties remains a clinical challenge. Methods: We reviewed the current literature regarding the practice of palliative medicine in the field of oncology, examining randomized clinical trials of palliative medicine services in advanced cancer, models of palliative medicine delivery, studies of cost effectiveness, and national palliative medicine practice and referral guidelines...
2017: Ochsner Journal
https://www.readbyqxmd.com/read/29223321/is-there-value-in-retrospective-90-day-bundle-payment-models-for-shoulder-arthroplasty-procedures
#6
Susan M Odum, Nady Hamid, Bryce A Van Doren, Leo R Spector
BACKGROUND: The Centers for Medicare & Medicaid Services Bundled Payments for Care Improvement (BPCI) initiative was implemented as part of the Affordable Care Act. We implemented a retrospective payment model 2 for a 90-day total shoulder arthroplasty (TSA) episode to assess the value of TSA BPCI at our private practice. METHODS: Expenditures and postacute event rates of 132 fee-for-service (FFS) patients who underwent a TSA operation between 2009 and 2012 were compared with 333 BPCI patients who had a TSA operation in 2015...
December 7, 2017: Journal of Shoulder and Elbow Surgery
https://www.readbyqxmd.com/read/29222338/blood-sample-transportation-by-pneumatic-transportation-systems-a-systematic-literature-review
#7
REVIEW
Mads Nybo, Merete E Lund, Kjell Titlestad, Christian U Maegaard
BACKGROUND: Pneumatic transportation systems (PTSs) are increasingly used for transportation of blood samples to the core laboratory. Many studies have investigated the impact of these systems on different types of analyses, but to elucidate whether PTSs in general are safe for transportation of blood samples, existing literature on the subject was systematically assessed. METHODS: A systematic literature review was conducted following the preferred reporting items for systematic reviews and metaanalyses (PRISMA) Statement guidelines to gather studies investigating the impact of PTS on analyses in blood samples...
December 8, 2017: Clinical Chemistry
https://www.readbyqxmd.com/read/29207729/comparison-of-different-dosing-protocols-of-anti-snake-venom-asv-in-snake-bite-cases
#8
B R Daswani, A S Chandanwale, D B Kadam, B B Ghongane, V S Ghorpade, H C Manu
Introduction: Considering the cost of Anti-Snake Venom (ASV) and irregularity in its supply, there is often a need to curtail doses of ASV, despite guidelines for management of snake bite. During June 2013 to September 2013, when ASV was in short supply, our institutional committee reviewed the overall hospital statistics of snake bite cases as well as scientific literature and formulated a working modified protocol that used low dose of ASV in snake bite cases. Aim: To retrospectively analyse and compare the modified ASV protocol versus conventional ASV protocol with respect to outcome, number of ASV vials required, duration of stay in the hospital/ ICU, and additional supportive interventions needed...
September 2017: Journal of Clinical and Diagnostic Research: JCDR
https://www.readbyqxmd.com/read/29203506/effectiveness-of-preoperative-medical-consultations-by-internal-medicine-physicians-a-systematic-review
#9
Clarabelle T Pham, Catherine L Gibb, Robert A Fitridge, Jonathan D Karnon
OBJECTIVE: Clinics have been established to provide preoperative medical consultations, and enable the anaesthetist and surgeon to deliver the best surgical outcome for patients. However, there is uncertainty regarding the effect of such clinics on surgical, in-hospital and long-term outcomes. A systematic review of the literature was conducted to determine the effectiveness of preoperative medical consultations by internal medicine physicians for patients listed for elective surgery...
December 3, 2017: BMJ Open
https://www.readbyqxmd.com/read/29202104/a-health-profile-of-senior-aged-women-veterans-a-latent-class-analysis-of-condition-clusters
#10
Margaret E Gonsoulin, Ramon A Durazo-Arvizu, Karen M Goldstein, Guichan Cao, Qiuying Zhang, Dharani Ramanathan, Denise M Hynes
Background and Objectives: This study characterizes the multiple morbidities experienced by senior-aged women Veterans so that the Veterans Health Administration (VHA) and other healthcare systems may be better prepared to meet the healthcare needs of this growing cohort. Research Design and Methods: Using the VHA's Corporate Data Warehouse (CDW), we conducted a retrospective observational study of the 38,597 female veteran patients who were at least sixty-five years old and received care in the VHA during 2013 and 2014...
September 1, 2017: Innovation in Aging
https://www.readbyqxmd.com/read/29201367/services-aimed-at-achieving-desirable-clinical-outcomes-in-patients-with-chronic-kidney-disease-and-diabetes-mellitus-a-narrative-review
#11
REVIEW
Fergus William Gardiner, Ezekiel Uba Nwose, Phillip Taderera Bwititi, Judith Crockett, Lexin Wang
There is a large number of patients with chronic kidney disease (CKD), diabetes mellitus (DM), and hypertension (HT) but whether the targets on blood pressure (BP) control in patients with DM and/or CKD are met is not clear. This narrative review therefore investigated evidence on services aimed at achieving desirable clinical results in patients with CKD and DM, and HT in Australia. Literature pertaining to pathology diagnosis and management of these patients as well as the complexities in management were considered...
2017: SAGE Open Medicine
https://www.readbyqxmd.com/read/29198638/guideline-for-discharge-opioid-prescriptions-after-inpatient-general-surgical-procedures
#12
Maureen V Hill, Ryland S Stucke, Sarah E Billmeier, Julia L Kelly, Richard J Barth
BACKGROUND: There is a paucity of data to inform appropriate opioid prescribing for patients who are discharged after a hospital admission for a surgical procedure. STUDY DESIGN: We studied 333 inpatients discharged to home after bariatric, benign foregut, liver, pancreas, ventral hernia, and colon surgery. Chronic opioid users or patients who had complications were excluded. Home opioid usage was quantified in 90% of the remaining patients by questionnaires and phone surveys...
November 8, 2017: Journal of the American College of Surgeons
https://www.readbyqxmd.com/read/29197143/do-mental-health-consumers-want-to-improve-their-long-term-disease-risk-behaviours-a-survey-of-over-2000-psychiatric-inpatients
#13
Kate Bartlem, Jacqueline Bailey, Alexandra Metse, Ashley Asara, Paula Wye, Richard Clancy, John Wiggers, Jenny Bowman
Policies and clinical guidelines acknowledge the role mental health services have in addressing the physical health of individuals with a mental illness; however, little research has explored interest in reducing health risk behaviours or the acceptability of receiving support to reduce such risks among psychiatric inpatients. This study estimated the prevalence of four long-term disease risk behaviours (tobacco smoking, hazardous alcohol consumption, inadequate fruit and/or vegetable consumption, and inadequate physical activity); patient interest in reducing these risks; and acceptability of being provided care to do so during a psychiatric inpatient stay...
December 2, 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/29194885/evaluating-effectiveness-in-adolescent-mental-health-inpatient-units-a-systematic-review
#14
REVIEW
Claire Hayes, Magenta Simmons, Christine Simons, Malcolm Hopwood
Adolescent mental health research is a developing area. Inpatient units are the most widely used acute element of adolescent mental health services internationally. Little is known about inpatient units, particularly when it comes to measuring improvement for adolescents. Clinical outcome measurement in the broad context has gathered momentum in recent years, driven by the need to assess services. The measurement of outcomes for adolescents who access inpatient care is critical, as they are particularly vulnerable and are often considered the most difficult to treat...
December 1, 2017: International Journal of Mental Health Nursing
https://www.readbyqxmd.com/read/29191700/health-care-utilization-in-the-first-month-after-birth-and-its-relationship-to-newborn-weight-loss-and-method-of-feeding
#15
Valerie Flaherman, Eric W Schaefer, Michael W Kuzniewicz, Sherian Li, Eileen Walsh, Ian M Paul
OBJECTIVE: Guidelines recommend closer outpatient follow-up for exclusively breastfed newborns, especially those with pronounced weight loss, because of increased risk of hyperbilirubinemia and dehydration that might require readmission. Our objective was to determine how feeding method and weight loss are associated with neonatal healthcare utilization. DESIGN: Retrospective cohort study. SETTING: Northern California Kaiser Permanente hospitals in 2009-2013 PATIENTS: 143,889 neonates PREDICTORS: Inpatient method of feeding and inpatient and outpatient weights MAIN OUTCOME MEASURES: Inpatient and outpatient utilization in the 30 days after birth RESULTS: Newborn weight loss and feeding method were each associated with utilization...
November 27, 2017: Academic Pediatrics
https://www.readbyqxmd.com/read/29189368/opioid-prescribing-for-the-treatment-of-acute-pain-in-children-on-hospital-discharge
#16
Constance L Monitto, Aaron Hsu, Shuna Gao, Paul T Vozzo, Paul S Park, Deborah Roter, Gayane Yenokyan, Elizabeth D White, Deepa Kattail, Amy E Edgeworth, Kelly J Vasquenza, Sara E Atwater, Joanne E Shay, Jessica A George, Barbara A Vickers, Sabine Kost-Byerly, Benjamin H Lee, Myron Yaster
BACKGROUND: The epidemic of nonmedical use of prescription opioids has been fueled by the availability of legitimately prescribed unconsumed opioids. The aim of this study was to better understand the contribution of prescriptions written for pediatric patients to this problem by quantifying how much opioid is dispensed and consumed to manage pain after hospital discharge, and whether leftover opioid is appropriately disposed of. Our secondary aim was to explore the association of patient factors with opioid dispensing, consumption, and medication remaining on completion of therapy...
December 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/29187385/national-trends-in-admission-and-in-hospital-mortality-of-patients-with-heart-failure-in-the-united-states-2001-2014
#17
Emmanuel Akintoye, Alexandros Briasoulis, Alexander Egbe, Shannon M Dunlay, Sudhir Kushwaha, Diane Levine, Luis Afonso, Dariush Mozaffarian, Jarrett Weinberger
BACKGROUND: To investigate heart failure (HF) hospitalization trends in the United States and change in trends after publication of management guidelines. METHODS AND RESULTS: Using data from the National Inpatient Sample and the US Census Bureau, annual national estimates in HF admissions and in-hospital mortality were estimated for years 2001 to 2014, during which an estimated 57.4 million HF-associated admissions occurred. Rates (95% confidence intervals) of admissions and in-hospital mortality among primary HF hospitalizations declined by an average annual rate of 3% (2...
November 29, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29186330/utilization-of-a-clinical-microbiology-service-at-a-cambodian-paediatric-hospital-and-its-impact-on-appropriate-antimicrobial-prescribing
#18
Shivani Fox-Lewis, Sreymom Pol, Thyl Miliya, Nicholas P J Day, Paul Turner, Claudia Turner
Background: Antimicrobial resistance threatens human health worldwide. Antimicrobial misuse is a major driver of resistance. Promoting appropriate antimicrobial use requires an understanding of how clinical microbiology services are utilized, particularly in resource-limited settings. Objectives: To assess the appropriateness of antimicrobial prescribing and the factors affecting utilization of the established clinical microbiology service (CMS). The CMS comprises the microbiology laboratory, clinical microbiologists (infection doctors) and antimicrobial treatment guidelines...
November 24, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/29185142/initial-and-long-term-impact-of-a-multi-disciplinary-task-force-in-the-diagnosis-and-management-of-heparin-induced-thrombocytopenia
#19
Ming Y Lim, Joyce Foster, Angela Rourk, Charles S Greenberg
Many medical centers are faced with a major challenge in making an accurate diagnosis of heparin-induced thrombocytopenia (HIT) and ensuring appropriate changes in management strategy in line with guideline recommendations. We report the initial and long-term impact and challenges of institution-wide changes in the diagnosis and management of HIT in the inpatient setting at an academic medical center. We established a HIT Task Force, consisting of a multidisciplinary team of non-malignant hematologists, nursing, pharmacist, pathology, blood bank and clinical lab informatics...
November 28, 2017: Journal of Thrombosis and Thrombolysis
https://www.readbyqxmd.com/read/29181524/challenging-case-of-parotitis-a-comprehensive-approach
#20
Puja Patel, Shannon Scott, Sean Cunningham
The diagnosis and management of parotitis can be challenging. Patients often present with pain and edema in the neck, jaw, head, and ear due to congestion of the gland. Parotitis is typically caused by an infection within the parotid gland and surrounding lymph nodes, and the infection can spread to nearby cervical fascial planes and cause major complications if not managed successfully. Specific guidelines for the outpatient management of parotitis are limited, and outpatient treatment failures are common, requiring inpatient therapy with multiple broad-spectrum antibiotics...
December 1, 2017: Journal of the American Osteopathic Association
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