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https://www.readbyqxmd.com/read/29777565/unanticipated-hospital-admission-in-pediatric-patients-with-congenital-heart-disease-undergoing-ambulatory-noncardiac-surgical-procedures
#1
Koichi Yuki, Sophia Koutsogiannaki, Sandra Lee, James A DiNardo
BACKGROUND: An increasing number of surgical and nonsurgical procedures are being performed on an ambulatory basis in children. Analysis of a large group of pediatric patients with congenital heart disease undergoing ambulatory procedures has not been undertaken. AIMS: The objective of this study was to characterize the profile of children with congenital heart disease who underwent noncardiac procedures on an ambulatory basis at our institution, to determine the incidence of adverse cardiovascular and respiratory adverse events, and to determine the risk factors for unscheduled hospital admission...
May 18, 2018: Paediatric Anaesthesia
https://www.readbyqxmd.com/read/29777549/frailty-risk-in-hospitalized-older-adults-with-and-without-diabetes-mellitus
#2
Deborah A Lekan, Thomas P McCoy
BACKGROUND: Research indicates that diabetes mellitus (DM) may be a risk factor for frailty and individuals with DM are more likely to be frail than individuals without DM, however, there is limited research in hospitalized older adults. OBJECTIVES: To determine the extent of frailty in hospitalized older adults with and without DM using a 16-item Frailty Risk Score (FRS) and assess the role of frailty in predicting 30-day rehospitalization, discharge to an institution, and in-hospital mortality...
May 18, 2018: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/29777388/a-retrospective-study-of-opioid-prescribing-patterns-at-hospital-discharge-in-surgical-patients-with-obstructive-sleep-apnea
#3
Samir M Kendale, Jing Wang, Jeanna D Blitz, Steven Calvino, Germaine Cuff, Nicholas Barone, Andrew D Rosenberg, Lisa Doan
PURPOSE: Obstructive sleep apnea (OSA) is a risk factor for complications with postoperative opioid use, and in those patients with known or suspected OSA, minimization of postoperative opioids is recommended. We hypothesize that despite these recommendations, surgical patients with known or suspected OSA are prescribed postoperative opioids at hospital discharge at similar doses to those without OSA. METHODS: This was a retrospective analysis of the electronic health records of surgical patients from 1 November 2016 to 30 April 2017 at a single academic institution...
May 18, 2018: Canadian Journal of Anaesthesia, Journal Canadien D'anesthésie
https://www.readbyqxmd.com/read/29777125/development-of-an-algorithm-to-identify-patients-with-physician-documented-insomnia
#4
Uri Kartoun, Rahul Aggarwal, Andrew L Beam, Jennifer K Pai, Arnaub K Chatterjee, Timothy P Fitzgerald, Isaac S Kohane, Stanley Y Shaw
We developed an insomnia classification algorithm by interrogating an electronic medical records (EMR) database of 314,292 patients. The patients received care at Massachusetts General Hospital (MGH), Brigham and Women's Hospital (BWH), or both, between 1992 and 2010. Our algorithm combined structured variables (such as International Classification of Diseases 9th Revision [ICD-9] codes, prescriptions, laboratory observations) and unstructured variables (such as text mentions of sleep and psychiatric disorders in clinical narrative notes)...
May 18, 2018: Scientific Reports
https://www.readbyqxmd.com/read/29776663/barriers-and-facilitators-to-diabetes-self-management-in-a-primary-care-setting-patient-perspectives
#5
Rahul Khairnar, Khalid M Kamal, Vincent Giannetti, Nilanjana Dwibedi, Jamie McConaha
BACKGROUND: Diabetes self-management (DSM) is a key element in the overall management of type-2 diabetes (T2DM). Identifying barriers and facilitators to DSM and addressing them is a critical step in achieving improved health outcomes in this population. OBJECTIVE: To assess patient reported barriers and facilitators to self-management of T2DM in a primary care setting. METHODS: This cross sectional study combined patient survey data with electronic medical record (EMR) data...
May 9, 2018: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29776436/rates-and-causes-of-30-day-readmission-and-emergency-room-utilization-following-head-and-neck-surgery
#6
Vincent Wu, Stephen F Hall
BACKGROUND: Unplanned returns to hospital are common, costly, and potentially avoidable. We aimed to investigate and characterize reasons for all-cause readmissions to hospital as in-patients (IPs) and visits to the Emergency Department (ED) within 30-days following patient discharge post head and neck surgery (HNS). METHODS: Retrospective case series with chart review. All patients within the Department of Otolaryngology - Head and Neck Surgery who underwent HNS for benign and malignant disease from January 1, 2010 to May 31, 2015 were identified...
May 18, 2018: Journal of Otolaryngology—Head & Neck Surgery
https://www.readbyqxmd.com/read/29775121/a-cohort-study-to-examine-the-use-of-chinese-herbal-medicine-in-combination-with-conventional-therapies-for-patients-with-hepatocellular-carcinoma-in-china
#7
Lingling Sun, Paul Fahey, Xiaoshu Zhu, Weng Ng, Zhuo Ping Chen, Yiwen Qiu, Hezheng Lai, Jietao Lin, Lizhu Lin
BACKGROUND: Hepatocellular carcinoma (HCC) is one of the major malignancies associated with high mortality rates. Chinese herbal medicine (CHM) alone, or in combination with conventional therapies (CT), has been widely used for patients with HCC in China. This study aims to explore how integrative therapy (IT) through the combination of CHM and CT affects the survival of patients with intermediate-advanced HCC. METHODS: A retrospective cohort study was performed at the First Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, China...
May 1, 2018: Integrative Cancer Therapies
https://www.readbyqxmd.com/read/29774497/safety-of-commercial-airflight-in-patients-with-brain-tumors-a-case-series
#8
Michelle Phillips, Marlon Saria, Amy Eisenberg, Daniel F Kelly, Garni Barkhoudarian
INTRODUCTION: Patients with intracranial masses are often advised to avoid airflight due to concerns of worsening neurological symptoms or deterioration. However, many patients often travel cross-country or internationally to tertiary care centers for definitive care. This study assesses the safety of commercial airflight for brain and skull base tumor patients without severe or progressive neurological deficits. METHODS: Patients that had traveled to our institution for surgery via commercial airflight from 2014 to 2017 were identified...
May 17, 2018: Journal of Neuro-oncology
https://www.readbyqxmd.com/read/29774453/predictors-for-adherence-to-multidisciplinary-follow-up-care-after-sleeve-gastrectomy
#9
Ariela Goldenshluger, R Elazary, M J Cohen, M Goldenshluger, T Ben-Porat, J Nowotni, H Geraisi, M Amun, A J Pikarsky, L Keinan-Boker
INTRODUCTION: A considerable proportion of patients who undergo bariatric surgeries (BS) do not attend routine postoperative follow-up despite recommendations for such. Data are sparse regarding the various aspects of patient adherence to consultations following sleeve gastrectomy (SG). OBJECTIVES: To examine predictors of adherence to SG follow-up, reasons for attrition from follow-up, and the relationship between adherence to follow-up and weight loss results...
May 17, 2018: Obesity Surgery
https://www.readbyqxmd.com/read/29773932/effectiveness-and-tolerability-of-therapy-with-once-weekly-exenatide-versus-basal-insulin-among-injectable-naive-patients-with-type-2-diabetes-in-a-real-world-setting-in-the-united-states
#10
Anita M Loughlin, Qing Qiao, Anthony P Nunes, Stephen M Ezzy, Laura Yochum, C Robin Clifford, Robert V Gately, David D Dore, John D Seeger
A propensity-matched cohort study compared injectable-naive patients with type 2 diabetes initiating exenatide once weekly (EQW) or basal insulin (BI), from 2012 through 2015, within a U.S. electronic health record database. A1C and weight were obtained as observed or multiply imputed values at baseline and quarterly for 1 year (Q1-Q4). Hypoglycemia and gastrointestinal symptoms were identified using diagnostic codes and clinical notes. EQW ( n = 2,008) and BI ( n = 4,016) cohorts were comparable at baseline (mean A1C and weight: EQW, 8...
May 2018: Diabetes Spectrum: a Publication of the American Diabetes Association
https://www.readbyqxmd.com/read/29773527/acceptability-and-feasibility-of-real-time-antiretroviral-therapy-adherence-interventions-in-rural-uganda-mixed-method-pilot-randomized-controlled-trial
#11
Angella Musiimenta, Esther C Atukunda, Wilson Tumuhimbise, Emily E Pisarski, Melanie Tam, Monique A Wyatt, Norma C Ware, Jessica E Haberer
BACKGROUND: Wireless electronic adherence monitors can detect antiretroviral therapy (ART) adherence lapses and trigger interventions in real time, thus potentially avoiding unnecessary HIV viremia. Evidence about the acceptability and feasibility of these monitors and associated interventions, however, is limited. OBJECTIVE: The aim of this study was to assess the acceptability and feasibility of real-time adherence monitoring linked to text messaging (short message service, SMS) reminders and notifications to support adherence among individuals living with HIV who are taking ART in rural southwestern Uganda...
May 17, 2018: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29773491/association-between-number-of-preventive-care-guidelines-and-preventive-care-utilization-by-patients
#12
Glen B Taksler, Elizabeth R Pfoh, Kurt C Stange, Michael B Rothberg
INTRODUCTION: The number of preventive care guidelines is rapidly increasing. It is unknown whether the number of guideline-recommended preventive services is associated with utilization. METHODS: The authors used Poisson regression of 390,778 person-years of electronic medical records data from 2008 to 2015, in 80,773 individuals aged 50-75 years. Analyses considered eligibility for 11 preventive services most closely associated with guidelines: tobacco cessation; control of obesity, hypertension, lipids, or blood glucose; influenza vaccination; and screening for breast, cervical, or colorectal cancers, abdominal aortic aneurysm, or osteoporosis...
May 8, 2018: American Journal of Preventive Medicine
https://www.readbyqxmd.com/read/29772946/safety-and-effectiveness-of-apixaban-in-comparison-to-warfarin-in-patients-with-nonvalvular-atrial-fibrillation-a-propensity-matched-analysis-from-japanese-administrative-claims-data
#13
Shun Kohsaka, Jun Katada, Kumiko Saito, Yasuo Terayama
OBJECTIVE: To investigate the risk of bleeding events and stroke/systemic embolism (SE) among Japanese patients with nonvalvular atrial fibrillation (NVAF), focusing on the initial dosage of apixaban and patient age. METHODS: This retrospective cohort study used de-identified electronic health records-based claims data from 314 acute-care hospitals in Japan. NVAF patients newly initiated on warfarin or apixaban, with no prescription during the 180-day blanking period, were eligible...
May 18, 2018: Current Medical Research and Opinion
https://www.readbyqxmd.com/read/29771861/vincristine-associated-neuropathy-with-antifungal-usage-a-kaiser-northern-california-experience
#14
Mina Nikanjam, Aida Sun, Mark Albers, Kristine Mangalindin, Eyun Song, Hyma Vempaty, Danny Sam, Edmund V Capparelli
The dose-limiting toxicity for vincristine is peripheral neuropathy which can be potentiated with concurrent usage of azole antifungals. The current retrospective study assessed the incidence of concurrent vincristine and azole antifungal usage to determine if it led to increased neurotoxicity for the Kaiser Northern California pediatric acute lymphoblastic leukemia (ALL) and Hodgkin lymphoma patient population. Data were obtained from the electronic medical record (2007 to 2014). In total, 130 subjects received at least one dose of vincristine for ALL or Hodgkin lymphoma (median age 9, 88% ALL, 58% male, 47% Caucasian)...
May 16, 2018: Journal of Pediatric Hematology/oncology
https://www.readbyqxmd.com/read/29771741/impacts-of-the-affordable-care-act-on-community-health-centers-characteristics-of-new-patients-and-early-changes-in-delivery-of-care
#15
Brigit Hatch, Ning Smith, Mary Ann McBurnie, Thu Quach, Kenneth H Mayer, Mary J Dunne, Erika Cottrell
The aim of this study was to assess the impact of the Affordable Care Act (ACA) on community health centers (CHCs). Using electronic health records from the Community Health Applied Research Network, we assessed new patient characteristics, office visit volume, and payer distribution among CHC patients before and after ACA implementation, 2011-2014 (n = 442 455). New patients post-ACA were younger, more likely to be female and have chronic health conditions, and utilized more primary care (P < .05 for each)...
May 15, 2018: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/29771353/predictors-for-identifying-burn-sepsis-and-performance-versus-existing-criteria
#16
David M Hill, Matthew D Percy, Sai R Velamuri, Julio Lanfranco, Ivan Romero Legro, Scott E Sinclair, William L Hickerson
Sepsis is the largest cause of mortality in thermally injured patients. Traditional SIRS criteria do not aid diagnosis of sepsis in burn centers. Studies have attempted identification of the best indicators of sepsis in the thermal injured patient, but predictive variables are inconsistent across the various studies. Currently, consensus guidelines lack evidential support as to which patients will benefit most from prompt antimicrobial therapy. The purpose of our study was to evaluate novel diagnostic parameters for thermal injured patients with known sepsis and compare these parameters with existing diagnostic criteria...
May 16, 2018: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/29771350/accuracy-of-the-medication-list-in-the-electronic-health-record-implications-for-care-research-and-improvement
#17
Kathleen E Walsh, Keith A Marsolo, Cori Davis, Theresa Todd, Bernadette Martineau, Carlie Arbaugh, Frederique Verly, Charles Samson, Peter Margolis
Objective: Electronic medication lists may be useful in clinical decision support and research, but their accuracy is not well described. Our aim was to assess the completeness of the medication list compared to the clinical narrative in the electronic health record. Methods: We reviewed charts of 30 patients with inflammatory bowel disease (IBD) from each of 6 gastroenterology centers. Centers compared IBD medications from the medication list to the clinical narrative...
May 15, 2018: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/29770887/the-importance-of-early-recognition-in-management-of-ercp-related-perforations
#18
Jason G Bill, Zachary Smith, Joseph Brancheck, Jeffrey Elsner, Paul Hobbs, Gabriel D Lang, Dayna S Early, Koushik Das, Thomas Hollander, Maria B Majella Doyle, Ryan C Fields, William G Hawkins, Steven M Strasberg, Chet Hammill, William C Chapman, Steven Edmundowicz, Daniel K Mullady, Vladimir M Kushnir
BACKGROUND: Iatrogenic perforations related to endoscopic retrograde cholangiopancreatography (ERCP) are rare events, carrying with it a mortality of up to 8%. Given the rarity of this adverse event, there remains limited data and continued uncertainties when choosing therapeutic strategies. Our aims were to evaluate the management of ERCP-related perforations and compare outcomes based on timing of recognition. METHODS: The endoscopic databases of two tertiary care centers were interrogated to identify consecutive adult patients who sustained ERCP-related perforation over a 10-year period from 2006 to 2016...
May 16, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29770874/electronic-voting-to-improve-morbidity-and-mortality-conferences
#19
Joel Zindel, Reto M Kaderli, Manuel O Jakob, Michel Dosch, Franziska Tschan, Daniel Candinas, Guido Beldi
BACKGROUND: It is of major importance in clinical surgery to identify potential patterns and specific causes of complications. Therefore, morbidity and mortality meetings (M&M) are widely used to discuss and evaluate deviations from expected outcomes in order to improve surgical practice. Moreover, M&M represent an important tool for continuous medical education. In this study, we introduced an electronic voting system to assess whether anonymity during M&M could limit potential biases due to hierarchical structures or opinion leaders...
May 16, 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/29770718/a-systematic-literature-review-comparing-methods-for-the-measurement-of-patient-persistence-and-adherence
#20
Carol A Forbes, Sohan Deshpande, Francesc Sorio-Vilela, Lucie Kutikova, Steven Duffy, Ioanna Gouni-Berthold, Emil Hagström
OBJECTIVES: A systematic literature review was conducted comparing different approaches estimating persistence and adherence in chronic diseases with polypharmacy of oral and subcutaneous treatments. METHODS: This work followed published guidance on performing systematic reviews. Twelve electronic databases and grey literature sources were used to identify studies and guidelines for persistence and adherence of oral and subcutaneous therapies in hypercholesterolemia, type 2 diabetes, hypertension, osteoporosis and rheumatoid arthritis...
May 17, 2018: Current Medical Research and Opinion
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