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https://www.readbyqxmd.com/read/29928997/prediction-task-guided-representation-learning-of-medical-codes-in-ehr
#1
Liwen Cui, Xiaolei Xie, Zuojun Shen
There have been rapidly growing applications using machine learning models for predictive analytics in Electronic Health Records (EHR) to improve the quality of hospital services and the efficiency of healthcare resource utilization. A fundamental and crucial step in developing such models is to convert medical codes in EHR to feature vectors. These medical codes are used to represent diagnoses or procedures. Their vector representations have a tremendous impact on the performance of machine learning models...
June 18, 2018: Journal of Biomedical Informatics
https://www.readbyqxmd.com/read/29928230/can-electronic-health-records-databases-complement-spontaneous-reporting-system-databases-a-historical-reconstruction-of-the-association-of-rofecoxib-and-acute-myocardial-infarction
#2
Vaishali K Patadia, Martijn J Schuemie, Preciosa M Coloma, Ron Herings, Johan van der Lei, Miriam Sturkenboom, Gianluca Trifirò
Background: Several initiatives have assessed if mining electronic health records (EHRs) may accelerate the process of drug safety signal detection. In Europe, Exploring and Understanding Adverse Drug Reactions (EU-ADR) Project Focused on utilizing clinical data from EHRs of over 30 million patients from several European countries. Rofecoxib is a prescription COX-2 selective Non-Steroidal Anti-Inflammatory Drugs (NSAID) approved in 1999. In September 2004, the manufacturer withdrew rofecoxib from the market because of safety concerns...
2018: Frontiers in Pharmacology
https://www.readbyqxmd.com/read/29928127/isolated-proximal-greater-saphenous-vein-thrombosis-and-the-risk-of-propagation-to-deep-vein-thrombosis-and-pulmonary-embolism
#3
Samuel H Kim, Nimesh Patel, Kanika Thapar, Ananda V Pandurangadu, Amit Bahl
Objectives: Greater saphenous vein (GSV) thrombosis is concerning due to its close proximity to the deep femoral vein. This study sought to identify the risk of propagation to deep vein thrombosis (DVT) or pulmonary embolism (PE) among patients with isolated proximal GSV superficial thrombosis and describe provider practice patterns related to treatment. Materials and methods: This is an Institutional Review Board-approved retrospective multi-center study. Patients presented to one of three possible emergency departments in a large health system...
2018: Vascular Health and Risk Management
https://www.readbyqxmd.com/read/29927906/interval-since-last-hiv-test-for-men-and-women-with-recent-risk-for-hiv-infection-united-states-2006-2016
#4
Marc A Pitasi, Kevin P Delaney, Emeka Oraka, Heather Bradley, Elizabeth A DiNenno, John T Brooks, Joseph Prejean
Since 2006, CDC has recommended routine screening of all persons aged 13-64 years for human immunodeficiency virus (HIV) and at least annual rescreening of persons at higher risk (1). However, national surveillance data indicate that many persons at higher risk for HIV infection are not screened annually, and delays in diagnosis persist (2). CDC analyzed 2006-2016 data from the General Social Survey (GSS)* and estimated that only 39.6% of noninstitutionalized U.S. adults had ever tested for HIV. Among persons ever tested, the estimated median interval since last test was 1,080 days or almost 3 years...
June 22, 2018: MMWR. Morbidity and Mortality Weekly Report
https://www.readbyqxmd.com/read/29927879/no-requirement-for-targeted-theophylline-levels-for-diuretic-effect-of-aminophylline-in-critically-ill-children
#5
Katie Park, Lindsay C Trout, Cong Xu, Ming Wang, Robert F Tamburro, E Scott Halstead
OBJECTIVES: To determine the relationship between theophylline trough levels and urine output in critically ill children administered aminophylline as adjunctive diuretic therapy. DESIGN: Retrospective cohort study. SETTING: The PICU of a tertiary care children's hospital. PATIENTS: A mixed population of medical/surgical including postoperative cardiothoracic surgery patients less than 18 years old. INTERVENTIONS: Electronic medical records of all PICU patients admitted from July 2010 to June 2015 were reviewed, and patients who received aminophylline as diuretic therapy were identified...
June 20, 2018: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/29927761/one-laryngospasm-2-realities-a-case-report-highlighting-the-impact-of-data-granularity-on-post-hoc-analysis-of-perioperative-events
#6
Allan F Simpao, Annie A Ma, Jonathan M Tan, Jack O Wasey, Aaron J Masino, Jorge A Gálvez
We present the case of a laryngospasm event in a 21-month-old child in which the changes in pulse oximetry and end-tidal carbon dioxide were recorded by both our Anesthesia Information Management System and middleware medical device integration platform. When this case was analyzed retrospectively, we noted that the 2 systems recorded the event very differently with respect to pulse oximetry. This case report illustrates the impact of data sampling rates on post hoc analysis of perioperative events and highlights the importance of understanding data collection processes when using electronically recorded data...
June 18, 2018: A&A practice
https://www.readbyqxmd.com/read/29927643/trends-in-homeless-children-and-young-adults-seeking-shelter-in-a-boston-pediatric-emergency-department-following-state-housing-policy-changes-2011-2016
#7
Mia Kanak, Amanda Stewart, Robert Vinci, Shanshan Liu, Megan Sandel
OBJECTIVES: To describe a trend in emergency department (ED) use by homeless children and young adults before and after a state housing policy change in 2012 and to quantify financial and time costs to the health care system. METHODS: We retrospectively reviewed de-identified electronic medical records of homeless children and young adults aged 0 to 21 years seeking shelter at an urban tertiary pediatric ED in Boston, Massachusetts, between September 1, 2011, and August 31, 2016...
June 21, 2018: American Journal of Public Health
https://www.readbyqxmd.com/read/29927641/disparities-in-smoking-cessation-assistance-in-us-primary-care-clinics
#8
Steffani R Bailey, John Heintzman, R Lorie Jacob, Jon Puro, Miguel Marino
OBJECTIVES: To examine associations between patient factors and smoking cessation assistance in US safety-net clinics. METHODS: Using electronic health record data from the OCHIN network, we identified adults with at least 1 primary care visit to a study clinic (n = 143 clinics in 12 states) with at least 1 documented "current smoker" status during 2014 to 2016 (n = 136 314; 29.8%). We estimated odds ratios (ORs) of smoking cessation assistance receipt (none [reference], counseling, medication, or both) by patient covariates...
June 21, 2018: American Journal of Public Health
https://www.readbyqxmd.com/read/29927457/validated-registry-of-pre-dialysis-chronic-kidney-disease-description-of-a-large-cohort
#9
Rosalia Maria Nunes Henriques Huaira, Rogerio Baumgratz de Paula, Marcus Gomes Bastos, Fernando Antonio Basile Colugnati, Natália Maria da Silva Fernandes
INTRODUCTION: Chronic diseases account for the majority of deaths in Brazil. These include hypertension (SAH) and diabetes mellitus (DM), which are the main causes of chronic kidney disease (CKD). OBJECTIVE: This study aimed to validate the data of an electronic health record and to point out characteristics of the profile of these users in relation to clinical quality indicators for a pre-dialytic CKD. METHODS: Retrospective cohort, August/2010 to December/2014...
June 7, 2018: Jornal Brasileiro de Nefrologia: ʹorgão Oficial de Sociedades Brasileira e Latino-Americana de Nefrologia
https://www.readbyqxmd.com/read/29926257/deprescribing-admission-medication-at-a-uk-teaching-hospital-a-report-on-quantity-and-nature-of-activity
#10
Sion Scott, Allan Clark, Carol Farrow, Helen May, Martyn Patel, Michael James Twigg, David John Wright, Debi Bhattacharya
Background Deprescribing medication may be in response to an adverse clinical trigger (reactive) or if future gains are unlikely to outweigh future harms (proactive). A hospital admission may present an opportunity for deprescribing, however current practice is poorly understood. Objective To quantify and describe the nature of deprescribing in a UK teaching hospital. Method Prescribing and discontinuation data for admission medication from a hospital's electronic prescribing system were extracted over 4 weeks...
June 20, 2018: International Journal of Clinical Pharmacy
https://www.readbyqxmd.com/read/29925332/development-modelling-and-pilot-testing-of-a-complex-intervention-to-support-end-of-life-care-provided-by-danish-general-practitioners
#11
Anna Kirstine Winthereik, Mette Asbjoern Neergaard, Anders Bonde Jensen, Peter Vedsted
BACKGROUND: Most patients in end-of-life with life-threatening diseases prefer to be cared for and die at home. Nevertheless, the majority die in hospitals. GPs have a pivotal role in providing end-of-life care at patients' home, and their involvement in the palliative trajectory enhances the patient's possibility to stay at home. The aim of this study was to develop and pilot-test an intervention consisting of continuing medical education (CME) and electronic decision support (EDS) to support end-of-life care in general practice...
June 20, 2018: BMC Family Practice
https://www.readbyqxmd.com/read/29924736/how-common-are-cognitive-errors-in-cases-presented-at-emergency-medicine-resident-morbidity-and-mortality-conferences
#12
David Chu, Jane Xiao, Payal Shah, Brett Todd
BACKGROUND: Cognitive errors are a major contributor to medical error. Traditionally, medical errors at teaching hospitals are analyzed in morbidity and mortality (M&M) conferences. We aimed to describe the frequency of cognitive errors in relation to the occurrence of diagnostic and other error types, in cases presented at an emergency medicine (EM) resident M&M conference. METHODS: We conducted a retrospective study of all cases presented at a suburban US EM residency monthly M&M conference from September 2011 to August 2016...
June 20, 2018: Diagnosis
https://www.readbyqxmd.com/read/29924681/identifying-and-understanding-the-gaps-in-care-experienced-by-adolescent-and-young-adult-cancer-patients-at-the-university-of-iowa-hospitals-and-clinics
#13
Erin M Mobley, Kristin J Foster, William W Terry
PURPOSE: In an effort to counteract the differences in improvement in survival rates of adolescents and young adults (AYA), compared to other age groups with cancer, the University of Iowa Hospitals and Clinics established an AYA cancer program. This study was conducted to gather feedback from AYAs in an effort to generate actionable data for program development. METHODS: The target population included patients aged 13-31 treated for malignancy in one of the following disease sites: central nervous system, leukemia, lymphoma, neuroendocrine, sarcoma, and thyroid...
June 20, 2018: Journal of Adolescent and Young Adult Oncology
https://www.readbyqxmd.com/read/29924024/systemic-lupus-erythematosus-with-guillian-barre-syndrome-a-case-report-and-literature-review
#14
Zhaoli Gao, Xianhua Li, Tao Peng, Zhao Hu, Jie Liu, Junhui Zhen, Yanxia Gao
INTRODUCTION: We report a case of systemic lupus erythematosus (SLE) with Guillian-Barre syndrome (GBS) as the first symptom. CASE PRESENTATION: A 30-year-old Chinese female with numbness and inductance of lower extremities 2 months previously. The electromyographic and cerebrospinal fluid findings supported inflammatory demyelinating disease, and the renal biopsy findings and rheumatoid-related results considered systemic lupus erythematosus. The patient received treatment with glucocorticoids and cyclophosphamide...
June 2018: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29923930/prophylactic-seizure-medication-and-health-related-quality-of-life-after-intracerebral-hemorrhage
#15
Andrew M Naidech, Jennifer Beaumont, Kathryn Muldoon, Eric M Liotta, Matthew B Maas, Matthew B Potts, Babak S Jahromi, David Cella, Shyam Prabhakaran, Jane L Holl
OBJECTIVES: Prophylactic levetiracetam is currently used in ~40% of patients with intracerebral hemorrhage, and the potential impact of levetircetam on health-related quality of life is unknown. We tested the hypothesis that prophylactic levetiracetam is independently associated with differences in cognitive function health-related quality of life. DESIGN: Patients with intracerebral hemorrhage were enrolled in a prospective cohort study. We performed mixed models for T-scores of health-related quality of life, referenced to the U...
June 19, 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29923235/interpersonal-relationships-and-safety-culture-in-brazilian-health-care-organisations
#16
Eliana R Migowski, Nery Oliveira Júnior, Fernando Riegel, Sérgio A Migowski
AIM: To examine the association between interpersonal relationships, nursing leadership and patient safety culture and the impact on the efficiency of hospitals. BACKGROUND: Hospitals are still affected by the increased complexity of the treatments offered and by the diverse knowledge of professionals involved, which has made this assistance model ineffective, expensive and unsustainable over time. METHOD: A qualitative study of 32 professionals from three large hospitals in Southern Brazil was made...
June 20, 2018: Journal of Nursing Management
https://www.readbyqxmd.com/read/29921349/clinical-diagnoses-leading-to-suspension-in-army-aircrew-an-epidemiological-study
#17
Ian P Curry, Amanda M Kelley, Steven J Gaydos
INTRODUCTION: There have been few large-scale epidemiological examinations of military aircrew populations reported in recent literature. This study examined 10 yr of medical records contained in the U.S. Army Aeromedical Electronic Resource Office (AERO) in an effort to identify the most prevalent conditions affecting Army aviator career longevity. METHODS: This study was a retrospective epidemiological review; data were retrieved on 24,568 rated aircrew patients from the AERO database, of whom 5...
July 1, 2018: Aerospace Medicine and Human Performance
https://www.readbyqxmd.com/read/29921177/-challenges-of-digital-medicine
#18
Jürg Blaser
Challenges of Digital Medicine Abstract. Digitization is increasingly covering more and more sectors, including medicine. To ensure medical operation 365 × 24 hours, progressively more human and financial resources are necessary. The transformation of patient histories from paper into electronic patient records focused initially on documentation. Today, hospital information systems are increasingly used as a platform for the communication of all professionals involved in the patient process - in Switzerland, however, so far without providing patients direct access to their data...
June 2018: Praxis
https://www.readbyqxmd.com/read/29920580/insights-from-the-geographic-spread-of-the-lyme-disease-epidemic
#19
Taylor Eddens, Daniel J Kaplan, Alyce J M Anderson, Andrew J Nowalk, Brian T Campfield
Background: Lyme disease is the most common reportable zoonotic infection in the United States. Recent data suggests spread of the Ixodes tick vector and increasing incidence of Lyme disease in several states, including Pennsylvania. We sought to determine the clinical presentation and healthcare utilization patterns for pediatric Lyme disease in western Pennsylvania. Methods: The electronic medical records of all patients with an ICD9 diagnosis of Lyme disease between 2003-2013 at Children's Hospital of Pittsburgh were individually reviewed for cases meeting the 2011 CDC case definition for Lyme disease...
June 16, 2018: Clinical Infectious Diseases: An Official Publication of the Infectious Diseases Society of America
https://www.readbyqxmd.com/read/29920144/gestational-weight-gain-and-pregnancy-complications-in-a-high-risk-racially-and-ethnically-diverse-population
#20
Zihe Zheng, Wendy L Bennett, Noel T Mueller, Lawrence J Appel, Xiaobin Wang
BACKGROUND: Evidence used to guide the current Institute of Medicine (IOM) gestational weight gain (GWG) recommendations is largely derived from studies of European descent, and as such the guidelines are the same for all races and ethnicities. The guidelines are also the same for prepregnancy obesity classes I through III. OBJECTIVE: Considering these literature gaps, we aim to (1) determine the association between the IOM GWG guidelines and three common pregnancy complications: preeclampsia, gestational diabetes mellitus, and cesarean delivery in a racially and ethnically diverse population; and (2) assess whether the association between GWG and pregnancy complications differs by race/ethnicity or prepregnancy body mass index (BMI) categories, particularly obesity classes I through III...
June 19, 2018: Journal of Women's Health
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