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https://www.readbyqxmd.com/read/29779274/-outcome-and-influential-factors-of-speech-therapy-delivered-to-cleft-patients-with-post-operative-velopharyngeal-competence
#1
Chun-Li Guo, Heng Yin, Jing-Tao Li, Cheng-Hao Li, Yang Li, Bing Shi, Qian Zheng
OBJECTIVE: To analyze the training technique, intervention timing, and other related factors involved in the speech therapy delivered to cleft patients with velopharyngeal competence after surgery. METHODS: A retrospective study was conducted on 32 patients who received phonology-articulation speech therapies during 2012 to 2013 in Dept. of Cleft Lip and Palate, West China Hospital of Stomatology, Sichuan University. All patients achieved normal speech one year after therapy...
April 1, 2018: Hua Xi Kou Qiang Yi Xue za Zhi, Huaxi Kouqiang Yixue Zazhi, West China Journal of Stomatology
https://www.readbyqxmd.com/read/29778671/international-study-of-comparative-health-effectiveness-with-medical-and-invasive-approaches-ischemia-trial-rationale-and-design
#2
David J Maron, Judith S Hochman, Sean M O'Brien, Harmony R Reynolds, William E Boden, Gregg W Stone, Sripal Bangalore, John A Spertus, Daniel B Mark, Karen P Alexander, Leslee Shaw, Jeffrey S Berger, T Bruce Ferguson, David O Williams, Robert A Harrington, Yves Rosenberg
BACKGROUND: Prior trials comparing a strategy of optimal medical therapy with or without revascularization have not shown that revascularization reduces cardiovascular events in patients with stable ischemic heart disease (SIHD). However, those trials only included participants in whom coronary anatomy was known prior to randomization and did not include sufficient numbers of participants with significant ischemia. It remains unknown whether a routine invasive approach offers incremental value over a conservative approach with catheterization reserved for failure of medical therapy in patients with moderate or severe ischemia...
April 21, 2018: American Heart Journal
https://www.readbyqxmd.com/read/29778610/a-decade-of-tevar-in-new-york-state-volumes-outcomes-and-implications-for-the-dissemination-of-endovascular-technology
#3
Jordan R Stern, Tianyi Sun, Jialin Mao, Art Sedrakyan, Andrew J Meltzer
INTRODUCTION: /Objectives: The purpose of this study was to characterize utilization and outcomes of TEVAR in New York State during the first decade of commercial availability, with respect to evolving indications, results, and costs. Of specific interest was evaluation of the volume-outcome relationship for this relatively uncommon procedure. METHODS: The New York Statewide Planning and Research Cooperative System (SPARCS) database was queried to identify patients undergoing TEVAR from 2005-2014 for aortic dissection (AD), non-ruptured aneurysm (NRA), and ruptured aneurysm (RA)...
May 17, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29778507/factors-associated-with-outcomes-and-inpatient-90-day-cost-of-care-in-endometrial-cancer-patients-undergoing-hysterectomy-implications-for-bundled-care-payments
#4
Aimee Rolston, Ryan J Spencer, R Kevin Reynolds, Laurel W Rice, Shitanshu Uppal
OBJECTIVE: To investigate the association of obesity and other comorbidities as well as route of surgery with postoperative outcomes, as well as 30- and 90-day inpatient cost of care after hysterectomy for endometrial cancer. METHODS: From the 2013 National Readmission Database release, patients who underwent hysterectomy for endometrial cancer were included. Obesity was classified as non-obese (body mass index [BMI] < 35 kg/m2 ); class I/II obesity (BMI ≥ 35 but <40 kg/m2 and without obesity related medical condition qualifying it as morbid obesity), class III obesity (BMI ≥ 40 kg/m2 OR BMI ≥ 35 kg/m2 with an obesity-related medical condition)...
May 16, 2018: Gynecologic Oncology
https://www.readbyqxmd.com/read/29778344/impact-of-clinical-pharmacist-engagement-in-ward-teams-on-the-number-of-drug-related-readmissions-among-swedish-older-patients-with-dementia-or-cognitive-impairment-an-economic-evaluation
#5
Maria Sjölander, Lars Lindholm, Bettina Pfister, Jeanette Jonsson, Jörn Schneede, Hugo Lövheim, Maria Gustafsson
BACKGROUND: Clinical pharmacists play an increasing role in the pharmacological treatment of hospital-admitted older patients with dementia or cognitive impairment. In an earlier randomised controlled trial, clinical pharmacist involvement in the ward team could significantly reduce drug-related readmissions in patient subgroups. However, the economic impact of the intervention has not been addressed so far. OBJECTIVES: To evaluate the economic impact of clinical pharmacist engagement in hospital ward teams for medication therapy management in older patients with dementia or cognitive impairments...
May 16, 2018: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/29777842/nationally-representative-readmission-factors-in-patients-with-claudication-and-critical-limb-ischemia
#6
Rennier A Martinez, Michelle Shnayder, Joshua Parreco, Lukas Gaffney, Marcus Eby, Nicholas Cortolillo, Michael Lopez, Jack Zeltzer
INTRODUCTION: Hospital readmissions are not only associated with increased mortality, morbidity and costs but also, with current healthcare reform, tied to significant financial and administrative penalties. Some studies show that patients undergoing vascular surgery may have higher than average readmission rates. The recently released Nationwide Readmission Database (NRD) is the most comprehensive national source of readmission data, gathering discharge information from 22 geographically dispersed states, accounting for 51...
May 16, 2018: Annals of Vascular Surgery
https://www.readbyqxmd.com/read/29777740/rapid-response-systems
#7
REVIEW
Patrick G Lyons, Dana P Edelson, Matthew M Churpek
INTRODUCTION: Rapid response systems are commonly employed by hospitals to identify and respond to deteriorating patients outside of the intensive care unit. Controversy exists about the benefits of rapid response systems. AIMS: We aimed to review the current state of the rapid response literature, including evolving aspects of afferent (risk detection) and efferent (intervention) arms, outcome measurement, process improvement, and implementation. DATA SOURCES: Articles written in English and published in PubMed...
May 16, 2018: Resuscitation
https://www.readbyqxmd.com/read/29777556/electrophysiology-and-structural-interventions-in-adults-with-congenital-heart-disease-comparison-of-combined-versus-separate-procedures
#8
Ian Lindsay, Farnoosh Nik-Ahd, Jamil A Aboulhosn, Jeremy P Moore
BACKGROUND: Electrophysiologic (EP) and structural interventions in adult congenital heart disease (ACHD) are typically completed during separate hospital encounters. With planning/coordination, these cases can be combined. OBJECTIVES: We hypothesized that this integrated approach would yield patient and health system benefits. METHODS: Consecutive ACHD patients undergoing combined interventions were matched to controls with identical but separate procedures...
May 18, 2018: Journal of Cardiovascular Electrophysiology
https://www.readbyqxmd.com/read/29777456/distal-bowel-re-feeding-in-patients-with-proximal-jejunostomy
#9
Anand Nagar, Siddharth Mehrotra, Amitabh Yadav, Vivek Mangla, Shailendra Lalwani, Naimish Mehta, Samiran Nundy
BACKGROUND: Patients who have a proximal jejunostomy are difficult to manage because of their high stoma output which results in fluid and electrolyte imbalance with repeated hospital admissions and the necessity for expensive parenteral nutrition (PN). There are few reports on the use of re-feeding of the proximal effluents in this situation. METHODS: We here relate our experience with this manoeuvre in 35 patients between Jan 2010 and Feb 2016 who had stomas less than 120 cm away from the duodenojejunal flexure...
May 18, 2018: Journal of Gastrointestinal Surgery: Official Journal of the Society for Surgery of the Alimentary Tract
https://www.readbyqxmd.com/read/29777350/the-american-association-for-the-surgery-of-trauma-emergency-general-surgery-anatomic-severity-scoring-system-as-a-predictor-of-cost-in-appendicitis
#10
Eric J Finnesgard, Matthew C Hernandez, Johnathon M Aho, Martin D Zielinski
BACKGROUND: The World Society for Emergency Surgery determined that for appendicitis managed with appendectomy, there is a paucity of evidence evaluating costs with respect to disease severity. The American Association for the Surgery of Trauma (AAST) disease severity grading system is valid and generalizable for appendicitis. We aimed to evaluate hospitalization costs incurred by patients with increasing disease severity as defined by the AAST. We hypothesized that increasing disease severity would be associated with greater cost...
May 17, 2018: Surgical Endoscopy
https://www.readbyqxmd.com/read/29776919/behaviour-modification-interventions-to-optimise-red-blood-cell-transfusion-practices-a-systematic-review-and-meta-analysis
#11
Lesley J J Soril, Thomas W Noseworthy, Laura E Dowsett, Katherine Memedovich, Hannah M Holitzki, Diane L Lorenzetti, Henry Thomas Stelfox, David A Zygun, Fiona M Clement
OBJECTIVE: To assess the impact of behaviour modification interventions to promote restrictive red blood cell (RBC) transfusion practices. DESIGN: Systematic review and meta-analysis. SETTING, PARTICIPANTS, INTERVENTIONS: Seven electronic databases were searched to January 2018. Published randomised controlled trials (RCTs) or non-randomised studies examining an intervention to modify healthcare providers' RBC transfusion practice in any healthcare setting were included...
May 18, 2018: BMJ Open
https://www.readbyqxmd.com/read/29776817/investigation-of-the-prevalence-of-pressure-ulcers-and-patient-related-risk-factors-in-hospitals-in-the-province-of-erzurum-a-cross-sectional-study
#12
Mağfiret Kaşıkçı, Meyreme Aksoy, Emrah Ay
BACKGROUND: Pressure ulcers are a significant health care problem all across the world due to their associated high mortality and morbidity rates and high health care costs. The prevalence of pressure ulcers serves as one of the most important indicators of the quality of nursing care. STUDY AIM: This study aims to determine the prevalence of pressure ulcers and patient-related risk factors in inpatients receiving treatment in the province of Erzurum, located in the eastern part of Turkey...
May 15, 2018: Journal of Tissue Viability
https://www.readbyqxmd.com/read/29776700/assessment-of-the-utility-of-ordering-a-troponin-in-low-and-intermediate-risk-patients-presenting-to-the-emergency-department-with-supraventricular-tachycardia-a-retrospective-chart-review
#13
David Noorvash, Rosemarie Ramos, Linda Hatch, Andrew Muck, Adriana Segura Olson
BACKGROUND: A troponin assay is commonly sent for patients presenting to emergency departments (EDs) with supraventricular tachycardia (SVT). Multiple studies suggest that elevated troponin levels do not predict coronary artery disease in these patients. Patients with elevated troponins are more likely to have additional cardiac testing, which can lead to increased health care costs and unnecessary invasive procedures. OBJECTIVE: Our objective was to evaluate low- to intermediate-risk patients (HEART [history, electrocardiography, age, risk factors and troponin] Score 1-6) presenting to the ED with SVT...
May 15, 2018: Journal of Emergency Medicine
https://www.readbyqxmd.com/read/29776444/mediastinal-staging-of-non-small-cell-lung-cancer-by-endobronchial-and-endoscopic-ultrasonography-with-or-without-additional-surgical-mediastinoscopy-mediastrial-study-protocol-of-a-multicenter-randomised-controlled-trial
#14
Jelle E Bousema, Marcel G W Dijkgraaf, Nicole E Papen-Botterhuis, Hermien W Schreurs, Jos G Maessen, Erik H van der Heijden, Willem H Steup, Jerry Braun, Valentin J J M Noyez, Fieke Hoeijmakers, Naomi Beck, Martijn van Dorp, Niels J M Claessens, Birgitta I Hiddinga, Johannes M A Daniels, David J Heineman, Harmen R Zandbergen, Ad F T M Verhagen, Paul E van Schil, Jouke T Annema, Frank J C van den Broek
BACKGROUND: In case of suspicious lymph nodes on computed tomography (CT) or fluorodeoxyglucose positron emission tomography (FDG-PET), advanced tumour size or central tumour location in patients with suspected non-small cell lung cancer (NSCLC), Dutch and European guidelines recommend mediastinal staging by endosonography (endobronchial ultrasound (EBUS) and endoscopic ultrasound (EUS)) with sampling of mediastinal lymph nodes. If biopsy results from endosonography turn out negative, additional surgical staging of the mediastinum by mediastinoscopy is advised to prevent unnecessary lung resection due to false negative endosonography findings...
May 18, 2018: BMC Surgery
https://www.readbyqxmd.com/read/29776436/rates-and-causes-of-30-day-readmission-and-emergency-room-utilization-following-head-and-neck-surgery
#15
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/29776369/prevention-and-treatment-of-malaria-in-pregnancy-what-do-pregnant-women-and-health-care-workers-in-east-india-know-and-do-about-it
#16
Lora Sabin, Evan M S Hecht, Mohamad I Brooks, Mrigendra P Singh, Kojo Yeboah-Antwi, Abanish Rizal, Blair J Wylie, Philip A Bondzie, Matthew Banos, Jordan Tuchman, Neeru Singh, Davidson H Hamer
BACKGROUND: Limited qualitative research has been performed in India to investigate views and behaviours of pregnant women regarding malaria despite the threat of malaria-related adverse maternal and neonatal outcomes. To address this gap, a comprehensive study on malaria prevention and treatment attitudes, knowledge and behaviour among pregnant women in India was conducted. METHODS: Pregnant women and healthcare workers (HCWs), encompassing clinic-based providers, traditional birth attendants, and auxiliary nurse-midwives were enrolled for in-depth interviews (IDIs) at 7 hospital sites and nearby communities in Jharkhand and Chhattisgarh States...
May 18, 2018: Malaria Journal
https://www.readbyqxmd.com/read/29776348/the-influence-of-cross-sectoral-treatment-models-on-patients-with-mental-disorders-in-germany-study-protocol-of-a-nationwide-long-term-evaluation-study-eva64
#17
Anne Neumann, Enno Swart, Dennis Häckl, Roman Kliemt, Stefanie March, Denise Küster, Katrin Arnold, Thomas Petzold, Fabian Baum, Martin Seifert, Jessika Weiß, Andrea Pfennig, Jochen Schmitt
BACKGROUND: Close, continuous and efficient collaboration between different professions and sectors of care is necessary to provide patient-centered care for individuals with mental disorders. The lack of structured collaboration between in- and outpatient care constitutes a limitation of the German health care system. Since 2012, a new law in Germany (§64b Social code book (SGB) V) has enabled the establishment of cross-sectoral and patient-centered treatment models in psychiatry. Such model projects follow a capitation budget, i...
May 18, 2018: BMC Psychiatry
https://www.readbyqxmd.com/read/29775978/-initiating-a-robotic-program-for-abdominal-surgery-experiences-from-a-centre-in-germany
#18
Maximilian Brunner, Klaus Matzel, Archil Aladashvili, Christian Krautz, Robert Grützmann, Roland Croner
PURPOSE: Robotic systems are becoming increasingly important in abdominal surgery. We describe the implementation of a robotic program at a German centre for abdominal surgery, with focus on feasibility, safety, patient selection, learning curves, financial aspects and the lessons learned. METHODS: This retrospective analysis covered data on patient demographics, intra- and postoperative parameters, oncological results and costs of all robotic-assisted abdominal operations performed at our institution between August 2012 to December 2016...
May 18, 2018: Zentralblatt Für Chirurgie
https://www.readbyqxmd.com/read/29775628/-cost-effectiveness-of-interventions-to-improve-hand-hygiene-in-healthcare-workers-in-middle-income-hospital-settings-a-model-based-analysis
#19
Nantasit Luangasanatip, Maliwan Hongsuwan, Yoel Lubell, Direk Limmathurotsakul, Pramot Srisamang, Nicholas Pj Day, Nicholas Graves, Ben S Cooper
BACKGROUND: Multimodal interventions are effective in increasing hand hygiene (HH) compliance amongst healthcare workers, but it is not known whether such interventions are cost-effective outside high-income countries. AIM: To evaluate the cost-effectiveness of multimodal hospital interventions to improve hand hygiene (HH) compliance in a middle-income country. METHOD: We adopted a conservative approach by developing a model to determine whether reductions in Methicillin-resistant Staphylococcus aureus bloodstream infections (MRSA-BSI) alone would make HH interventions cost-effective in intensive care units (ICUs)...
May 15, 2018: Journal of Hospital Infection
https://www.readbyqxmd.com/read/29775604/the-use-of-stitching-and-bioabsorbable-mesh-and-glue-to-combat-prolonged-air-leaks
#20
Toshiki Tanaka, Kazuhiro Ueda, Junichi Murakami, Kimikazu Hamano
Prolonged postoperative air leaks are associated with extended periods of postoperative hospitalization, increased hospital costs, and an increased incidence of major cardiopulmonary complications. To prevent prolonged air leaks, we used small pieces of polyglycolic acid mesh as a pledget during the stitching of air leak sites. The stitched sites were then covered with mesh and fibrin glue. This novel technique showed the highest airway pressure tolerance in an ex vivo experimental study. There were no incidents of prolonged air leak among the five clinical cases in which this technique was initially applied...
May 15, 2018: Annals of Thoracic Surgery
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