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https://www.readbyqxmd.com/read/28434533/performance-of-fixed-heart-rate-increment-targets-of-20-vs-30-beats-per-minute-for-exercise-rehabilitation-prescription-in-outpatients-with-heart-failure
#1
Jennifer L Reed, Angelica Z Blais, Marja-Leena Keast, Andrew L Pipe, Robert D Reid
BACKGROUND: Patients with heart failure (HF) should exercise at 40%-60% heart rate reserve (HRR) during the first 3 weeks of an outpatient cardiac rehabilitation (CR) program and at 50%-80% HRR thereafter. Arbitrary methods to prescribe exercise intensity such as resting HR (RHR) plus 20 or 30 beats per minute (bpm) (RHR + 20 or RHR + 30) are recommended for inpatients after a myocardial infarction or those recovering from heart surgery. This approach has been repurposed by outpatient CR programs to prescribe exercise intensity for patients with HF, yet its efficacy has not been evaluated...
February 2, 2017: Canadian Journal of Cardiology
https://www.readbyqxmd.com/read/28430557/utilization-management-of-high-cost-imaging-in-an-outpatient-setting-in-a-large-stable-patient-and-provider-cohort-over-7-years
#2
Jeffrey B Weilburg, Christopher L Sistrom, Daniel I Rosenthal, Markus B Stout, Keith J Dreyer, Helaine R Rockett, Jason M Baron, Timothy G Ferris, James H Thrall
Purpose To quantify the effect of a comprehensive, long-term, provider-led utilization management (UM) program on high-cost imaging (computed tomography, magnetic resonance imaging, nuclear imaging, and positron emission tomography) performed on an outpatient basis. Materials and Methods This retrospective, 7-year cohort study included all patients regularly seen by primary care physicians (PCPs) at an urban academic medical center. The main outcome was the number of outpatient high-cost imaging examinations per patient per year ordered by the patient's PCP or by any specialist...
April 21, 2017: Radiology
https://www.readbyqxmd.com/read/28430046/an-outpatient-methadone-weaning-program-by-a-neonatal-intensive-care-unit-for-neonatal-abstinence-syndrome
#3
Andrew Lai, Patrick Philpot, Jenny Boucher, Andrew Meyer
Through retrospective chart review, this study described characteristics and length of stay for a cohort of newborns discharged on methadone following an inpatient weaning for neonatal abstinence syndrome (NAS). Data were assessed for all term infants born between January 1, 2010, and December 31, 2014, admitted to the hospital with a co-diagnosis of NAS at discharge, for gestational age, length of stay, days on treatment protocol before discharge, time to once-daily interval methadone dosing, and hospital charges, as well as for categorical characteristics...
April 21, 2017: Population Health Management
https://www.readbyqxmd.com/read/28426362/predicting-change-in-an-integrated-dual-diagnosis-substance-abuse-intensive-outpatient-program
#4
Edward A Wise, David L Streiner, Robert J Gallop
Research on routine outcome monitoring in psychotherapy settings is plentiful but not without implementation obstacles. In fact, there is a relative dearth of real-time outcome monitoring in substance use treatment settings. Numerous barriers to the development and implementation of clinical decision support tools and outcome monitoring of substance use patients, including the need to establish expected trajectories of change and use of reliable change indices have been identified (Goodman, McKay, & DePhilippis, 2013 )...
June 7, 2017: Substance Use & Misuse
https://www.readbyqxmd.com/read/28412900/reducing-behavioral-health-inpatient-readmissions-for-people-with-substance-use-disorders-do-follow-up-services-matter
#5
Sharon Reif, Andrea Acevedo, Deborah W Garnick, Catherine A Fullerton
OBJECTIVE: Individuals with substance use disorders are at high risk of hospital readmission. This study examined whether follow-up services received within 14 days of discharge from an inpatient hospital stay or residential detoxification reduced 90-day readmissions among Medicaid enrollees whose index admission included a substance use disorder diagnosis. METHODS: Claims data were analyzed for Medicaid enrollees ages 18-64 with a substance use disorder diagnosis coded in any position for an inpatient hospital stay or residential detoxification in 2008 (N=30,439)...
April 17, 2017: Psychiatric Services: a Journal of the American Psychiatric Association
https://www.readbyqxmd.com/read/28409699/potential-for-medicaid-savings-a-state-and-national-comparison-of-an-innovative-neonatal-abstinence-syndrome-treatment-model
#6
Lori Dickes, Julie Summey, Rachel Mayo, Jennifer Hudson, Windsor Westbrook Sherrill, Liwei Chen
In recent years, neonatal abstinence syndrome (NAS) rates have increased rapidly across the United States, rising from 1.2 (2000) to 5.8 (2012) per 1000 hospital births annually. Because most NAS infants are treated in an intensive care setting, associated hospital charges are high and continue to escalate, rising on average from $39,400 in 2000 to $66,700 in 2012. An innovative NAS treatment program, which includes early-initiated methadone therapy, rooming-in, and combined inpatient/outpatient weaning in a low-acuity nursery, has been in place since 2003 at a large Southeastern hospital...
April 14, 2017: Population Health Management
https://www.readbyqxmd.com/read/28366335/the-association-between-insomnia-symptoms-and-cardiovascular-risk-factors-in-patients-who-complete-outpatient-cardiac-rehabilitation
#7
Codie R Rouleau, Kirsti Toivonen, Sandeep Aggarwal, Ross Arena, Tavis S Campbell
OBJECTIVE: The present study investigated whether completion of an exercise-based cardiac rehabilitation (CR) program was associated with improvements in both traditional cardiovascular risk factors and insomnia symptoms, and whether degree of improvement in insomnia symptom severity was associated with degree of improvement in cardiovascular risk. METHODS: Participants (N = 80) with cardiovascular disease completed a 12-week outpatient CR program involving supervised moderate-intensity exercise sessions held twice weekly...
April 2017: Sleep Medicine
https://www.readbyqxmd.com/read/28359235/halving-your-cake-and-eating-it-too-a-case-based-discussion-and-review-of-metabolic-rehabilitation-for-obese-adults-with-diabetes
#8
R Bishay, N Kormas
BACKGROUND: The global epidemic of obesity will see normal weight adults constituting a mere one-third of the global population by 2025. Although appetite and weight are regulated by a complex integration of neurological, endocrine and gastrointestinal feedback mechanisms, there is a constant interaction between psychological state, physical impairment, presence of comorbid chronic disease and medications. METHODS: We discuss two cases and reveal a practical approach to investigating and managing patients with obesity and diabetes in the 'real world'...
March 29, 2017: Current Diabetes Reviews
https://www.readbyqxmd.com/read/28358754/open-label-study-of-injectable-extended-release-naltrexone-xr-ntx-in-healthcare-professionals-with-opioid-dependence
#9
Paul H Earley, Jacqueline Zummo, Asli Memisoglu, Bernard L Silverman, David R Gastfriend
OBJECTIVES: Healthcare professionals (HCPs) with opioid dependence are at risk for relapse and death, particularly in the first year of recovery; however, maintenance treatment with opioid agonists is controversial in this safety-sensitive group. We evaluated long-term safety, tolerability, and treatment outcomes of injectable, intramuscular, extended-release naltrexone (XR-NTX) in opioid-dependent HCPs. METHODS: This single-arm, multisite, open-label study was conducted in opioid-dependent HCPs who had been detoxified from opioids for at least 2 weeks...
March 29, 2017: Journal of Addiction Medicine
https://www.readbyqxmd.com/read/28338229/response-to-endurance-exercise-training-in-older-adults-with-heart-failure-with-preserved-or-reduced-ejection-fraction
#10
Ambarish Pandey, Dalane W Kitzman, Peter Brubaker, Mark J Haykowsky, Timothy Morgan, J Thomas Becton, Jarett D Berry
OBJECTIVES: To systematically examine the relative magnitude and predictors of responses to exercise training in older adult with heart failure (HF) with reduced ejection fraction (HFrEF), and preserved EF (HFpEF). DESIGN: Secondary analysis of a randomized controlled trial. SETTING: Outpatient cardiac rehabilitation program. PARTICIPANTS: Individuals with HF (24 HFrEF, 24 HFpEF) who underwent supervised exercise training...
March 24, 2017: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/28329406/treating-veterans-with-ptsd-and-borderline-personality-symptoms-in-a-12-week-intensive-outpatient-setting-findings-from-a-pilot-program
#11
Laura Meyers, Emily K Voller, Ethan B McCallum, Paul Thuras, Sandra Shallcross, Tina Velasquez, Laura Meis
Rates of comorbidity between borderline personality disorder and posttraumatic stress disorder (PTSD) are high in veteran populations, and clinicians are hesitant to treat PTSD given high rates of suicidality. Given promising early work integrating dialectical behavior therapy (DBT) and prolonged exposure (PE) therapy, we created a 12-week intensive outpatient program combining these two treatments. PE and DBT were provided concurrently to 33 veterans with PTSD symptoms and BPD symptoms at a large, midwestern Veteran Affairs medical center...
March 22, 2017: Journal of Traumatic Stress
https://www.readbyqxmd.com/read/28299791/prospective-pilot-study-of-the-mastering-each-new-direction-psychosocial-family-systems-program-for-pediatric-chronic-illness
#12
Brian Distelberg, Daniel Tapanes, Natacha D Emerson, Whitney N Brown, Deepti Vaswani, Jackie Williams-Reade, Ara M Anspikian, Susanne Montgomery
Psychosocial interventions for pediatric chronic illness (CI) have been shown to support health management. Interventions that include a family systems approach offer potentially stronger and more sustainable improvements. This study explores the biopsychosocial benefits of a novel family systems psychosocial intervention (MEND: Mastering Each New Direction). Forty-five families participated in a 21-session intensive outpatient family systems-based program for pediatric CI. Within this single arm design, families were measured on five domains of Health-Related Quality of Life (HRQL) self-report measures; Stress, Cognitive Functioning, Mental Health, Child HRQL, Family Functioning...
March 15, 2017: Family Process
https://www.readbyqxmd.com/read/28290830/-efficacy-of-home-based-exercise-training-and-adherence-to-therapy-in-patients-after-coronary-artery-bypass-grafting
#13
S A Pomeshkina, E B Loktionova, N V Arkhipova, O L Barbarash
AIM: to assess efficacy of home-based exercise training (HBET) at outpatient stage of cardiac rehabilitation and its impact on adherence to treatment in patients after coronary artery bypass grafting (CABG). MATERIAL AND METHODS: In 1 month after CABG 112 male patients (after completion of rehabilitation program in the sanatorium) were distributed to 3 groups with comparable demographic, clinical, and functional parameters: group 1 - patients fulfilling supervised cycling training program (SCTP), group 2 - patients subjected to home-based exercise training (HBET) with defined walking sessions (WS), and the control group of usual care without exercise training...
January 2017: Kardiologiia
https://www.readbyqxmd.com/read/28279948/remote-monitoring-of-hypertension-diseases-in-pregnancy-a-pilot-study
#14
Dorien Lanssens, Thijs Vandenberk, Christophe Jp Smeets, Hélène De Cannière, Geert Molenberghs, Anne Van Moerbeke, Anne van den Hoogen, Tiziana Robijns, Sharona Vonck, Anneleen Staelens, Valerie Storms, Inge M Thijs, Lars Grieten, Wilfried Gyselaers
BACKGROUND: Although remote monitoring (RM) has proven its added value in various health care domains, little is known about the remote follow-up of pregnant women diagnosed with a gestational hypertensive disorders (GHD). OBJECTIVE: The aim of this study was to evaluate the added value of a remote follow-up program for pregnant women diagnosed with GHD. METHODS: A 1-year retrospective study was performed in the outpatient clinic of a 2nd level prenatal center where pregnant women with GHD received RM or conventional care (CC)...
March 9, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28258368/-outpatient-multimodal-pain-therapy-results-of-a%C3%A2-1-week-intensive-outpatient-multimodal-group-program-for-patients-with-chronic-unspecific-back-pain-retrospective-evaluation-after-3-and-12-months
#15
T Reck, W Dumat, J Krebs, A Ljutow
BACKGROUND: Interdisciplinary pain therapy is nowadays the state of the art for the treatment of chronic unspecific back pain. The aim of this article is to present the retrospective analysis of the data from a 1-week intensive outpatient multimodal interdisciplinary pain therapy group program for treatment of patients with chronic unspecific back pain. DESIGN AND METHODS: The questionnaire-based data from patients who attended the program were evaluated before as well as 3 and 12 months after finishing the program...
March 3, 2017: Der Schmerz
https://www.readbyqxmd.com/read/28220023/early-palliative-care-reduces-end-of-life-intensive-care-unit-icu-use-but-not-icu-course-in-patients-with-advanced-cancer
#16
Andrew M Romano, Kristine E Gade, Gradon Nielsen, Robert Havard, James H Harrison, Josh Barclay, George J Stukenborg, Paul W Read, Leslie J Blackhall, Patrick M Dillon
BACKGROUND: Early palliative care for advanced cancer patients improves quality of life and survival, but less is known about its effect on intensive care unit (ICU) use at the end of life. This analysis assessed the effect of a comprehensive early palliative care program on ICU use and other outcomes among patients with advanced cancer. PATIENTS AND METHODS: A retrospective cohort of patients with advanced cancer enrolled in an early palliative care program (n = 275) was compared with a concurrent control group of patients receiving standard care (n = 195) during the same time period by using multivariable logistic regression analysis...
March 2017: Oncologist
https://www.readbyqxmd.com/read/28207662/expression-of-mirna-124a-in-cd4-cells-reflects-response-to-a-multidisciplinary-treatment-program-in-patients-with-chronic-low-back-pain
#17
Benjamin Luchting, Jens Heyn, Ludwig Christian Hinske, Shahnaz Christina Azad
STUDY DESIGN: A prospective evaluation of microRNA (miRNA) expression in patients with chronic low back pain (CLBP). OBJECTIVE: The aim of this study was to evaluate whether pain- and T cell-related miRNAs are differentially expressed in CLBP when compared with healthy volunteers and whether these miRNAs may distinguish between responders and nonresponders to a multidisciplinary treatment program. SUMMARY OF BACKGROUND DATA: CLBP is a common health problem worldwide...
February 15, 2017: Spine
https://www.readbyqxmd.com/read/28204835/pain-and-functional-outcomes-after-outpatient-physiotherapy-in-patients-with-low-back-pain
#18
Martin Alfuth, Dieter W Welsink
BACKGROUND: Physiotherapy treatment programs are recommended in the rehabilitation of low back pain (LBP). Rehabilitation institutions are increasingly asked to demonstrate the outcomes of their intensive physiotherapy services. AIM: To describe pain and functional outcome measures following a 6-month outpatient physiotherapy treatment program in patients with LBP. METHODS: A total of 85 patients were analysed after being treated with a combination of physiotherapeutic treatment modalities 2-3 days weekly...
February 15, 2017: Der Orthopäde
https://www.readbyqxmd.com/read/28195939/care-for-vulnerable-elderly-in-cardiology-a-program-for-daily-practice
#19
Mirjam A M Wit, Annet J C M Bos-Schaap, Victor A W M Umans
BACKGROUND: The percentage of cardiac patients aged ≥75 has increased considerably over the past decades. To optimize multidisciplinary care for these frail elderly, a program of intensive medical and nursing care was started at Noord West Ziekenhuisgroep department of cardiology. METHODS: Patients over 70 years of age, admitted to the department of cardiology, were included and treated by the advanced practice nurse according to a redesigned care process that focused on expedite mobilization and care by an advanced practice nurse-headed team including the first outpatient visit...
March 2017: Critical Pathways in Cardiology
https://www.readbyqxmd.com/read/28194410/acute-feasibility-of-neuromuscular-electrical-stimulation-in-severely-obese-patients-with-obstructive-sleep-apnea-syndrome-a-pilot-study
#20
RANDOMIZED CONTROLLED TRIAL
Isabelle Vivodtzev, Nicola A Maffiuletti, Anne-Laure Borel, Angélique Grangier, Bernard Wuyam, Renaud Tamisier, Jean-Louis Pépin
Objective. Obesity and obstructive sleep apnea (OSA) are closely interconnected conditions both leading to high cardiovascular risk. Inactivity is frequent and physical activity programs remain difficult in these patients. We investigated the acute feasibility of two neuromuscular electrical stimulation (NMES) modalities in extremely inactive obese patients with OSA. Design. A randomized cross-over study, with two experimental sessions (one per condition: multipath NMES versus conventional NMES). Setting. Outpatient research hospital...
2017: BioMed Research International
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