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https://www.readbyqxmd.com/read/28637090/early-warning-systems-and-rapid-response-to-the-deteriorating-patient-in-hospital-a-realist-evaluation
#1
Jennifer Mcgaughey, Peter O'Halloran, Sam Porter, John Trinder, Bronagh Blackwood
AIM: To identify those contexts and mechanisms that enable or constrain the implementation of Rapid Response Systems on acute general hospital wards to recognise and respond to patient deterioration. BACKGROUND: Rapid Response Systems allow deteriorating patients to be recognised using Early Warning Systems, referred early via escalation protocols and managed at the bedside by competent staff. DESIGN: Realist Evaluation. METHODS: The research design was an embedded multiple case study approach of four wards in two hospitals in Northern Ireland which followed the principles of Realist Evaluation...
June 21, 2017: Journal of Advanced Nursing
https://www.readbyqxmd.com/read/28636702/analysis-of-survival-after-initiation-of-continuous-renal-replacement-therapy-in-a-surgical-intensive-care-unit
#2
James M Tatum, Galinos Barmparas, Ara Ko, Navpreet Dhillon, Eric Smith, Daniel R Margulies, Eric J Ley
Importance: Continuous renal replacement therapy (CRRT) benefits patients with renal failure who are too hemodynamically unstable for intermittent hemodialysis. The duration of therapy beyond which continued use is futile, particularly in a population of patients admitted to and primarily cared for by a surgical service (hereinafter referred to as surgical patients), is unclear. Objective: To analyze proportions of and independent risk factors for survival to discharge after initiation of CRRT among patients in a surgical intensive care unit (SICU)...
June 21, 2017: JAMA Surgery
https://www.readbyqxmd.com/read/28634502/impact-of-neurological-follow-up-on-early-hospital-readmission-rates-for-acute-ischemic-stroke
#3
Alexander Allen, Todd Barron, Ashley Mo, Richard Tangel, Ruth Linde, Rodney Grim, John Mingle, Ellen Deibert
INTRODUCTION: Despite advances in stroke care, readmission rates for patients with ischemic stroke remain high. Although factors such as age, diabetes, and continuous use of antiplatelet agents have been found to predict readmission rates, the impact of after-hospital care has not been examined. METHODS: The present study reviewed the charts of 416 patients with acute ischemic stroke and recorded stroke-related comorbidities, neurology follow-up within 21 days, readmission at 0 to 30 days, readmission at 31 to 90 days, and any reasons for readmission...
July 2017: Neurohospitalist
https://www.readbyqxmd.com/read/28634002/acupressure-therapy-for-acute-ankle-sprains-a-randomized-clinical-trial
#4
Mingxing Zhao, Wei Gao, Long Zhang, Wei Huang, Sihua Zheng, Guanliang Wang, Brian Y Hong, Baoyong Tang
BACKGROUND: Ankle sprains occur frequently among young and active people, accounting for almost two million injuries per year. Previous reports suggest that acupressure therapy for acute ankle sprains may shorten the recovery time. OBJECTIVE: To evaluate whether acupressure therapy can improve ankle sprain recovery when compared to standard RICE (rest, ice, compression, and elevation) treatment. DESIGN: A randomized controlled trial was conducted...
June 17, 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28633650/effects-of-tolvaptan-in-patients-with-acute-heart-failure-a-systematic-review-and-meta-analysis
#5
Chunbin Wang, Bo Xiong, Lin Cai
BACKGROUND: Acute heart failure, which requires urgent evaluation and treatment, is a leading cause for admission to the emergency department. The aim of this meta-analysis was to evaluate the effects of tolvaptan on acute heart failure and compare them with the effects of conventional therapy or placebo. METHODS: The electronic databases PubMed, EMBASE, and the Cochrane Controlled Trial registry were searched from their starting dates to October 24, 2016. Two authors independently read the trials and extracted related information from the included studies...
June 20, 2017: BMC Cardiovascular Disorders
https://www.readbyqxmd.com/read/28633534/neuromuscular-electrical-stimulation-improves-exercise-tolerance-in-patients-with-advanced-heart-failure-on-continuous-intravenous-inotropic-support-use-randomized-controlled-trial
#6
Patrícia Forestieri, Douglas W Bolzan, Vinícius B Santos, Rita Simone Lopes Moreira, Dirceu Rodrigues de Almeida, Renata Trimer, Flávio de Souza Brito, Audrey Borghi-Silva, Antonio Carlos de Camargo Carvalho, Ross Arena, Walter J Gomes, Solange Guizilini
OBJECTIVE: To evaluate the impact of a short-term neuromuscular electrical stimulation program on exercise tolerance in hospitalized patients with advanced heart failure who have suffered an acute decompensation and are under continuous intravenous inotropic support. DESIGN: A randomized controlled study. SUBJECTS: Initially, 195 patients hospitalized for decompensated heart failure were recruited, but 70 were randomized. INTERVENTION: Patients were randomized into two groups: control group subject to the usual care ( n = 35); neuromuscular electrical stimulation group ( n = 35) received daily training sessions to both lower extremities for around two weeks...
June 1, 2017: Clinical Rehabilitation
https://www.readbyqxmd.com/read/28633483/an-informatics-research-agenda-to-support-patient-and-family-empowerment-and-engagement-in-care-and-recovery-during-and-after-hospitalization
#7
Sarah Collins, Patricia Dykes, David W Bates, Brittany Couture, Ronen Rozenblum, Jennifer Prey, Kristin O'Reilly, Patricia Q Bourie, Cindy Dwyer, S Ryan Greysen, Jeffery Smith, Michael Gropper, Anuj K Dalal
As part of an interdisciplinary acute care patient portal task force with members from 10 academic medical centers and professional organizations, we held a national workshop with 71 attendees representing over 30 health systems, professional organizations, and technology companies. Our consensus approach identified 7 key sociotechnical and evaluation research focus areas related to the consumption and capture of information from patients, care partners (eg, family, friends), and clinicians through portals in the acute and post-acute care settings...
June 17, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28632784/contemporary-use-of-p2y12-inhibitors-in-patients-with-acute-coronary-syndrome-undergoing-percutaneous-coronary-intervention-in-austria-a-prospective-multi-centre-registry
#8
Maximilian Tscharre, Florian Egger, Matthias Machata, Miklos Rohla, Nadia Michael, Manuel Neumayr, Robert Zweiker, Johannes Hajos, Christopher Adlbrecht, Markus Suppan, Wolfgang Helmreich, Bernd Eber, Kurt Huber, Thomas W Weiss
BACKGROUND: To this day, there is no data concerning guideline adherence on P2Y12-inhibitors in Austria. Prasugrel and ticagrelor have been shown to be superior to clopidogrel in the treatment of acute coronary syndromes (ACS). However, recent data from European registries showed a reluctant prescription policy with rates of clopidogrel at discharge ranging from 35 to 55%. METHODS: In this prospective, multi-centre registry we assessed prescription rates of P2Y12-inhibitors in patients with ACS in four Austrian PCI centres...
2017: PloS One
https://www.readbyqxmd.com/read/28631744/traumatic-cervical-spinal-cord-injury-a-prospective-clinical-study-of-laryngeal-penetration-and-aspiration
#9
T Ihalainen, I Rinta-Kiikka, T M Luoto, E A Koskinen, A-M Korpijaakko-Huuhka, A Ronkainen
STUDY DESIGN: Prospective cohort study. OBJECTIVES: Dysphagia is a relatively common secondary complication in patients with traumatic cervical spinal cord injuries (TCSCI). The purpose of this study was to determine the incidence of aspiration and penetration in patients with acute TCSCI. SETTING: Tampere University Hospital, Tampere, Finland. METHODS: A total of 46 patients with TCSCI were evaluated with a videofluoroscopic swallowing study (VFSS)...
June 20, 2017: Spinal Cord
https://www.readbyqxmd.com/read/28629448/azithromycin-for-idiopathic-acute-exacerbation-of-idiopathic-pulmonary-fibrosis-a-retrospective-single-center-study
#10
Kodai Kawamura, Kazuya Ichikado, Yuko Yasuda, Keisuke Anan, Moritaka Suga
BACKGROUND: Acute exacerbation (AE) of idiopathic pulmonary fibrosis (IPF) is a fatal condition without an established pharmaceutical treatment. Most patients are treated with high-dose corticosteroids and broad-spectrum antibiotics. Azithromycin is a macrolide with immunomodulatory activity and may be beneficial for treatment of acute lung injury. The objective of this study was to determine the effect of azithromycin on survival of patients with idiopathic AE of IPF. METHODS: We evaluated 85 consecutive patients hospitalized in our department for idiopathic AE of IPF from April 2005 to August 2016...
June 19, 2017: BMC Pulmonary Medicine
https://www.readbyqxmd.com/read/28629285/acute-movement-disorders-in-the-medical-setting
#11
Ifrah Zawar, Mario A Caro, Lara Feldman, Xavier F Jimenez
Objective Psychosomatic medicine psychiatrists are often tasked with the evaluation and treatment of complex neuropsychiatric states which may be motoric in phenotype. Little energy has been dedicated to understanding acute movement disorders in the hospital environment. Method Recognizing the importance of frontal-subcortical (corticostriatothalamocortical) circuitry and basal ganglia structures, we present a case series of acute movement disorder phenotypes resulting from underlying medical conditions, commonly-administered medications, or the interaction of both...
July 2016: International Journal of Psychiatry in Medicine
https://www.readbyqxmd.com/read/28629167/igg-avidity-test-in-congenital-toxoplasmosis-diagnoses-in-newborns
#12
Zulmirene Cardoso Fonseca, Isolina Maria Xavier Rodrigues, Natália Cruz E Melo, Juliana Boaventura Avelar, Ana Maria Castro, Mariza Martins Avelino
The goal of this study was to investigate the importance of IgG avidity testing in newborns (NBs) diagnosed with early congenital toxoplasmosis. We collected samples from 88 puerperae infected by Toxoplasma gondii (T. gondii) and their NBs (48 acutely-infected puerperae (AIP) and 40 chronically-infected puerperae (CIP)), from two public maternity hospitals in Goiania city, Goias, Brazil, from 2010 to 2015. Specific anti-T. gondii IgM and IgG serum levels and IgG avidity tests were evaluated using chemiluminescence...
June 18, 2017: Pathogens
https://www.readbyqxmd.com/read/28628885/use-of-antidepressants-and-risk-of-hospitalization-for-acute-myocardial-infarction-a-nationwide-case-crossover-study
#13
Chi-Shin Wu, Hsiao-Ting Wu, Yu-Ting Tsai, Ya-Wen Huang, Hui-Ju Tsai
BACKGROUND: We aimed to investigate the association between antidepressant use and the risk of hospitalization for acute myocardial infarction (AMI). METHODS: A case-crossover study was conducted using a nationwide population-based sample from Taiwan's National Health Insurance Research Database. A total of 18,631 patients with incident AMI were included in this study. The effects of antidepressant use as well as that of various classes (including tricyclic or tetracyclic antidepressants; selective serotonin reuptake inhibitors; or serotonin norepinephrine reuptake inhibitors), doses, and receptor-binding profiles of the antidepressants on AMI were assessed...
June 3, 2017: Journal of Psychiatric Research
https://www.readbyqxmd.com/read/28628521/experiences-of-acute-pain-in-children-who-present-to-a-healthcare-facility-for-treatment-a-systematic-review-of-qualitative-evidence
#14
Nicole Pope, Mary Tallon, Ruth McConigley, Gavin Leslie, Sally Wilson
BACKGROUND: Pain is a universal and complex phenomenon that is personal, subjective and specific. Despite growing knowledge in pediatric pain, management of children's pain remains sub-optimal and is linked to negative behavioral and physiological consequences later in life. As there is no synthesis of these studies, it was timely to undertake a systematic review. OBJECTIVES: To identify, evaluate and synthesize the existing qualitative evidence on children's experiences of acute pain, including pain management, within a healthcare facility...
June 2017: JBI Database of Systematic Reviews and Implementation Reports
https://www.readbyqxmd.com/read/28628498/earlier-physical-therapy-input-is-associated-with-a-reduced-length-of-hospital-stay-and-reduced-care-needs-on-discharge-in-frail-older-inpatients-an-observational-study
#15
Peter J Hartley, Victoria L Keevil, Ledia Alushi, Rebecca L Charles, Eimear B Conroy, Patricia M Costello, Becki Dixon, Aida M Dolinska-Grzybek, Diana Vajda, Roman Romero-Ortuno
BACKGROUND AND PURPOSE: Pressures on hospital bed occupancy in the English National Health Service have focused attention on enhanced service delivery models and methods by which physical therapists might contribute to effective cost savings, while retaining a patient-centered approach. Earlier access to physical therapy may lead to better outcomes in frail older inpatients, but this has not been well studied in acute National Health Service hospitals. Our aim was to retrospectively study the associations between early physical therapy input and length of hospital stay (LOS), functional outcomes, and care needs on discharge...
June 16, 2017: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/28628139/-effect-of-particulate-air-pollution-on-hospital-admissions-for-acute-exacerbation-of-chronic-obstructive-pulmonary-disease-in-beijing
#16
Y Cao, H Liu, J Zhang, K W Huang, H Y Zhao, Y Yang, S Y Zhan
OBJECTIVE: To assess the association between particulate air pollution and hospital admissions for acute exacerbation of chronic obstructive pulmonary disease (AECOPD) in Beijing, and to evaluate the differences of association among different subgroups. METHODS: Hospital admissions to intertiary hospitals for AECOPD from January 1, 2014, through December 31, 2015 were obtained from the electronic hospitalization summary reports (HSRs).We obtained the data on air pollution during the study period from the national air pollution monitoring system...
June 18, 2017: Beijing da Xue Xue Bao. Yi Xue Ban, Journal of Peking University. Health Sciences
https://www.readbyqxmd.com/read/28627932/short-term-prognostic-effect-of-prior-cerebrovascular-and-peripheral-artery-disease-in-patients-with-acute-coronary-syndrome-can-we-do-better
#17
Filipa Cordeiro, Pedro S Mateus, Alberto Ferreira, Silvia Leao, Miguel Moz, J Ilidio Moreira
BACKGROUND: We sought to evaluate the impact of prior cerebrovascular and/or peripheral arterial disease (PAD) on in-hospital outcomes in patients with acute coronary syndromes. METHODS: From 1 October 2010 to 26 February 2016, 13,904 acute coronary syndrome patients were enrolled in a national multicentre registry. They were divided into four groups: prior stroke/transient ischaemic attack (stroke/TIA); prior PAD; prior stroke/TIA and PAD; none. The endpoints included in-hospital mortality and a composite endpoint of death, re-infarction and stroke during hospitalization...
June 1, 2017: European Heart Journal. Acute Cardiovascular Care
https://www.readbyqxmd.com/read/28627445/right-sided-acute-diverticulitis-a-single-western-center-experience
#18
Francesco Monari, Maurizio Cervellera, Basilio Pirrera, Umberto D'Errico, Samuele Vaccari, Laura Alberici, Valeria Tonini
INTRODUCTION: Right sided diverticular disease is a rare condition in Western countries whereas is common amongst Asian population. The aim of this study is to evaluate options and outcomes for the treatment of right colonic diverticulitis. METHOD: We included only patients undergoing surgery with right colon diverticulitis (RCD) proven at histological specimen examination from September 2011 to December 2016. RESULTS: We performed 18 operations for RCD...
June 13, 2017: International Journal of Surgery
https://www.readbyqxmd.com/read/28627275/the-effects-of-exercise-on-patient-reported-outcomes-and-performance-based-physical-function-in-adults-with-acute-leukemia-undergoing-induction-therapy
#19
Ashley Leak Bryant, Allison M Deal, Claudio L Battaglini, Brett Phillips, Mackenzi Pergolotti, Erin Coffman, Matthew C Foster, William A Wood, Charlotte Bailey, Anthony C Hackney, Deborah K Mayer, Hyman B Muss, Bryce B Reeve
INTRODUCTION: Fatigue is a distressing symptom for adults with acute leukemia, often impeding their ability to exercise. OBJECTIVES: 1) Examine effects of a 4-week mixed-modality supervised exercise program (4 times a week, twice a day) on fatigue in adults with acute leukemia undergoing induction chemotherapy. 2) Evaluate effects of exercise program on cognition, anxiety, depression, and sleep disturbance. 3) Evaluate effect of intervention on adherence to exercise...
March 1, 2017: Integrative Cancer Therapies
https://www.readbyqxmd.com/read/28626336/rehabilitation-in-a-convalescent-rehabilitation-ward-following-an-acute-ward-improves-functional-recovery-and-mortality-for-hip-fracture-patients-a-sequence-in-a-single-hospital
#20
Tomohiro Yoshizawa, Tomofumi Nishino, Hajime Mishima, Takeshi Ainoya, Masashi Yamazaki
[Purpose] The convalescent rehabilitation ward (CRW) plays an important role for hip fracture patients in Japanese super-aged society. The purpose of this study is to clarify the usefulness of the CRW concomitant with acute wards in a single hospital. [Subjects and Methods] 110 hip fracture patients were evaluated; 63 patients were moved from acute wards to the CRW in the same hospital (Group C) and 47 patients were treated in acute wards only (Group A). Patient selection was determined by each attending doctor...
June 2017: Journal of Physical Therapy Science
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