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https://www.readbyqxmd.com/read/28535535/inflammation-is-an-important-covariate-for-the-crosstalk-of-sleep-and-the-hpa-axis-in-rheumatoid-arthritis
#1
Rainer H Straub, Jaqueline Detert, René Dziurla, Ingo Fietze, Peter-Andreas Loeschmann, Gerd R Burmester, Frank Buttgereit
Rheumatoid arthritis (RA) patients have sleep problems, and inflammation influences sleep. We demonstrated that sleep quality improves during intensified treatment with methotrexate (MTX) or etanercept (ETA). Since the hypothalamic-pituitary-adrenal (HPA) axis is involved in sleep regulation, this study investigated the interrelation between sleep parameters, inflammation as objectified by C-reactive protein (CRP), and serum cortisol and adrenocorticotropic hormone (ACTH) levels. Thirty-one eligible patients (disease activity score, DAS28CRP ≥3...
May 24, 2017: Neuroimmunomodulation
https://www.readbyqxmd.com/read/28535139/otitis-media-with-effusion-our-national-practice
#2
Rachel E Roditi, Richard M Rosenfeld, Jennifer J Shin
Otitis media with effusion (OME) is the focus of an updated multidisciplinary clinical practice guideline published by the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) and the American Academy of Pediatrics (AAP). Based on data from clinical trials, the guideline recommends against using antihistamines, antibiotics, oral steroids, and intranasal steroids for OME. To understand practice patterns related to these guidelines, we assessed nationally representative data. Despite controlling for age, sex, race/ethnicity, and other potential confounders individualized for each medication class, an increased risk of antihistamine (odds ratio [OR], 3...
April 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28535109/intranasal-steroid-use-for-otitis-media-with-effusion-ongoing-opportunities-for-quality-improvement
#3
David E Wang, Derek J Lam, Angela M Bellmunt, Richard M Rosenfeld, Allison K Ikeda, Jennifer J Shin
Objectives Our objectives were (1) to assess patterns of intranasal steroid administration when otitis media with effusion (OME) has been diagnosed in children, (2) to investigate whether usage varies according to visit setting, and (3) to determine if practice gaps are such that quality improvement could be tracked. Study Design Cross-sectional analysis of an administrative database. Subjects and Methods National Ambulatory and Hospital Ambulatory Medical Care Surveys, 2005 to 2012; univariate, multivariate, and stratified analyses of intranasal steroid usage were performed...
May 1, 2017: Otolaryngology—Head and Neck Surgery
https://www.readbyqxmd.com/read/28533006/association-between-preoperative-albumin-levels-and-length-of-stay-after-radical-cystectomy
#4
Rohan G Bhalla, Li Wang, Sam S Chang, Mark D Tyson
PURPOSE: Using contemporary population-based epidemiologic data, we measured the relationship between preoperative serum albumin level and hospital length of stay (LOS) after cystectomy and urinary diversion. MATERIALS & METHODS: Data was acquired from the 2014-2015 National Surgical Quality Improvement Program (NSQIP) database. We identified 1,582 adult patients who underwent a cystectomy between January 1st 2014 and December 31st 2015 and had a documented preoperative serum albumin level...
May 19, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28532409/variation-in-prosthetic-joint-infection-and-treatment-strategies-during-4-5%C3%A2-years-of-follow-up-after-primary-joint-arthroplasty-using-administrative-data-of-41397-patients-across-australian-european-and-united-states-hospitals
#5
Perla J Marang-van de Mheen, Ellie Bragan Turner, Susan Liew, Nora Mutalima, Ton Tran, Sten Rasmussen, Rob G H H Nelissen, Andrew Gordon
BACKGROUND: To identify best practices and quality improvement initiatives, we aimed to assess whether the incidence of Periprosthetic Joint Infection (PJI) and treatment strategies differed across patients treated in Australian, European and United States (US) hospitals. METHODS: Routinely collected administrative data for 41397 patients undergoing a primary total hip or knee arthroplasty between July 2007-December 2010 across 22 hospitals were included. Patients were followed for 2 years looking for PJI occurrence, defined as early (within 4 weeks) and late PJI, and surgical treatment during 2...
May 22, 2017: BMC Musculoskeletal Disorders
https://www.readbyqxmd.com/read/28531653/characteristics-needs-and-experiences-of-u-s-veterans-on-a-specialized-prison-unit
#6
Jack Tsai, Elizabeth Goggin
The Veterans Service Unit (VSU) in Connecticut is one of several all-veterans prison units that are being created throughout the United States. This study examined the characteristics, needs, and experiences of veterans on the Connecticut VSU. This study utilized data from a quality improvement survey that was completed by 87 of the 110 veterans on the Connecticut VSU (79% response rate). The majority of veterans on the VSU were white, aged 41-56, never married, and had an honorable or general military discharge making them potentially eligible for Veterans Affairs (VA) healthcare upon release...
May 17, 2017: Evaluation and Program Planning
https://www.readbyqxmd.com/read/28530670/transfusion-practices-for-bone-marrow-harvests-a-survey-analysis-from-the-aabb-bone-marrow-quality-improvement-initiative-working-group
#7
T R Spitzer, M W Sugrue, C Gonzalez, P O'Donnell, D Confer, E Fuchs, M A Pulsipher, J Schwartz, M Linenberger
No abstract text is available yet for this article.
May 22, 2017: Bone Marrow Transplantation
https://www.readbyqxmd.com/read/28530526/warfarin-management-and-outcomes-in-patients-with-nonvalvular-atrial-fibrillation-within-an-integrated-health-care-system
#8
JaeJin An, Fang Niu, Chengyi Zheng, Nazia Rashid, Robert A Mendes, Diana Dills, Lien Vo, Prianka Singh, Amanda Bruno, Daniel T Lang, Paul T Le, Kristin P Jazdzewski, Gustavus Aranda
BACKGROUND: Warfarin is a common treatment option to manage patients with nonvalvular atrial fibrillation (NVAF) in clinical practice. Understanding current pharmacist-led anticoagulation clinic management patterns and associated outcomes is important for quality improvement; however, currently little evidence associating outcomes with management patterns exists. OBJECTIVES: To (a) describe warfarin management patterns and (b) evaluate associations between warfarin treatment and clinical outcomes for patients with NVAF in an integrated health care system...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28529465/using-stakeholder-input-to-inform-an-innovative-research-and-policy-initiative-to-improve-depression-in-safety-net-communities
#9
Dmitry Khodyakov, Pluscedia Williams, Elizabeth Bromley, Bowen Chung, Kenneth Wells
THE PROBLEM: Depression quality improvement programs based on chronic disease management models have been shown to improve depression outcomes. Nonetheless, access to and the use of such programs is limited in minority, under-resourced communities. PURPOSE OF ARTICLE: We report on the outcomes of a Delphi-based consensus exercise conducted by our partnership at a community-wide conference in Los Angeles. Participants identified and prioritized the needs of depressed individuals that should be addressed in a county-wide Health Neighborhood Initiative designed to increase existing mental health, substance use, healthcare, and social services for individuals with low socioeconomic position...
2017: Progress in Community Health Partnerships: Research, Education, and Action
https://www.readbyqxmd.com/read/28529095/understanding-operator-stent-choice-in-the-catheterization-laboratory-using-a-pre-procedure-survey-opportunities-for-quality-improvement
#10
Matthew J Chung, Jonathan D Hansen, Ryan D Schulteis, Joel C Boggan, W Schuyler Jones, Thomas J Povsic, Susan Roberts, Mitchell W Krucoff, Sunil V Rao
OBJECTIVES: We sought to characterize how the perceived risk of early dual antiplatelet therapy (DAPT) discontinuation is incorporated into operator decision-making regarding stent choice, using a simple pre-procedure survey screening for clinical variables that may lead to early DAPT discontinuation. BACKGROUND: Understanding which factors influence operator decision-making regarding stent choice during percutaneous coronary intervention (PCI) could help identify areas for quality improvement...
May 8, 2017: Cardiovascular Revascularization Medicine: Including Molecular Interventions
https://www.readbyqxmd.com/read/28528753/healthcare-access-and-quality-index-based-on-mortality-from-causes-amenable-to-personal-health-care-in-195-countries-and-territories-1990-2015-a-novel-analysis-from-the-global-burden-of-disease-study-2015
#11
(no author information available yet)
BACKGROUND: National levels of personal health-care access and quality can be approximated by measuring mortality rates from causes that should not be fatal in the presence of effective medical care (ie, amenable mortality). Previous analyses of mortality amenable to health care only focused on high-income countries and faced several methodological challenges. In the present analysis, we use the highly standardised cause of death and risk factor estimates generated through the Global Burden of Diseases, Injuries, and Risk Factors Study (GBD) to improve and expand the quantification of personal health-care access and quality for 195 countries and territories from 1990 to 2015...
May 18, 2017: Lancet
https://www.readbyqxmd.com/read/28528624/root-cause-analysis-of-adverse-events-in-an-outpatient-anticoagulation-management-consortium
#12
Christopher M Graves, Brian Haymart, Eva Kline-Rogers, Geoffrey D Barnes, Linda K Perry, Denise Pluhatsch, Nannette Gearhart, Helen Gikas, Noelle Ryan, Brian Kurtz
BACKGROUND: A number of factors can lead to adverse events (AEs) in patients taking warfarin. Performing a root cause analysis (RCA) of serious AEs is one systematic way of determining the causes of these events. METHODS: Multidisciplinary teams were formed at Michigan Anticoagulation Quality Improvement Initiative (MAQI(2)) sites with organized anticoagulation management services (AMS). Medical records from patients who suffered serious AEs (major bleed, embolic stroke, venous thromboembolism) were reviewed, and AMS staff were interviewed to determine the root cause using the "5 Whys" technique...
June 2017: Joint Commission Journal on Quality and Patient Safety
https://www.readbyqxmd.com/read/28527930/outcomes-of-open-and-endovascular-lower-extremity-revascularization-in-active-smokers-with-advanced-peripheral-arterial-disease
#13
Samuel L Chen, Matthew D Whealon, Nii-Kabu Kabutey, Isabella J Kuo, Michael D Sgroi, Roy M Fujitani
OBJECTIVE: Concern over perioperative and long-term durability of lower extremity revascularizations among active smokers is a frequent deterrent for vascular surgeons to perform elective lower extremity revascularization. In this study, we examined perioperative outcomes of lower extremity endovascular (LEE) revascularization and open lower extremity bypass (LEB) in active smokers with intermittent claudication (IC) and critical limb ischemia (CLI). METHODS: Active smokers undergoing LEE or LEB from 2011 to 2014 were identified in the American College of Surgeons (ACS) National Surgical Quality Improvement Program (NSQIP) targeted vascular data set...
June 2017: Journal of Vascular Surgery
https://www.readbyqxmd.com/read/28527635/shared-decision-making-in-preventive-care-in-switzerland-from-theory-to-action
#14
Kevin Selby, Reto Auer, Jacques Cornuz
Switzerland with its decentralized, liberal health system and its tradition of direct democracy may be an ideal place for shared decision making (SDM) to take root organically, rather than using top-down regulations seen in other countries. There are now multiple directives and programmes in place to encourage SDM, with the creation of several decision aids and specific training programs in the five Swiss medical schools. There has been an emphasis on preventive care, with the integration of patient preference into an organized colorectal cancer screening program, clear recommendations for prostate cancer screening, and inroads into the primary prevention of cardiovascular disease...
May 17, 2017: Zeitschrift Für Evidenz, Fortbildung und Qualität Im Gesundheitswesen
https://www.readbyqxmd.com/read/28527506/technology-enabled-population-health-management-two-communities-use-of-an-electronic-care-alert-system
#15
REVIEW
Todd Rowland, Jill Nielsen-Farrell, Kathy Church, Barbara Riddell
Population health management is an approach to improve the health outcomes of a specific group of people, such as frequent users of the emergency department or those at high-risk for hospital admissions. When combined with quality improvement strategies, the targeted application of health information exchange and health information technology (health IT) can swiftly move health care systems and providers from basic to advanced population health management. One such tool is an electronic alert system (alert system), which informs a provider or site about a patient's visit to the emergency department or hospital admission on a daily basis...
May 2017: PM & R: the Journal of Injury, Function, and Rehabilitation
https://www.readbyqxmd.com/read/28526961/simultaneous-conversion-of-gastric-band-to-sleeve-gastrectomy-is-associated-with-increased-postoperative-complications-an-analysis-of-the-american-college-of-surgeons-national-surgical-quality-improvement-program
#16
Zachary C Dietch, Bruce D Schirmer, Peter T Hallowell
BACKGROUND: Laparoscopic sleeve gastrectomy (LSG) has gained popularity for the treatment of morbid obesity as gastric banding (BAND) has fallen out of favor. As a result, simultaneous conversion (CONV) of BAND to LSG is commonly performed. We hypothesized that CONV is associated with higher 30-day risk-adjusted serious morbidity. METHODS: Preoperative characteristics and 30-day outcomes from the American College of Surgeons National Surgical Quality Improvement Program Participant Use Files 2010-2014 were selected for patients who underwent LSG...
May 19, 2017: Surgical Endoscopy
https://www.readbyqxmd.com/read/28526220/lumbar-puncture-for-all-febrile-infants-29-56-days-old-a-retrospective-cohort-reassessment-study
#17
Richard Scarfone, Ashlee Murray, Payal Gala, Fran Balamuth
OBJECTIVES: To determine the incidence of bacterial meningitis (BM) among all febrile infants 29-56 days old undergoing a lumbar puncture (LP) in the emergency department of a tertiary care children's hospital and the number of low-risk febrile infants with BM to reassess the need for routine LP in these infants. STUDY DESIGN: Retrospective cohort study using a quality improvement registry from July 2007-April 2014. Infants included were 29-56 days old with fever and who had an LP in the emergency department...
May 16, 2017: Journal of Pediatrics
https://www.readbyqxmd.com/read/28525558/electronic-clinical-quality-measure-reporting-challenges-findings-from-the-medicare-ehr-incentive-program-s-controlling-high-blood-pressure-measure
#18
Dawn M Heisey-Grove, Hilary K Wall, Janet S Wright
Objective: To identify physician and practice characteristics associated with high clinical and technical performance on the electronic clinical quality measure (eCQM) that calculates the proportion of patients with hypertension who have controlled blood pressure. Materials and Methods: The study included 268 602 physicians participating in the Medicare Electronic Health Record Incentive Program between 2011 and 2014. Independent variables included delivery reform participation and physician, practice level, and area characteristics...
May 19, 2017: Journal of the American Medical Informatics Association: JAMIA
https://www.readbyqxmd.com/read/28525513/an-observational-assessment-of-anesthesia-capacity-in-madagascar-as-a-prerequisite-to-the-development-of-a-national-surgical-plan
#19
Linden S Baxter, Vaonandianina A Ravelojaona, Hasiniaina N Rakotoarison, Alison Herbert, Emily Bruno, Kristin L Close, Vanessa Andean, Hery H Andriamanjato, Mark G Shrime, Michelle C White
BACKGROUND: The global lack of anesthesia capacity is well described, but country-specific data are needed to provide country-specific solutions. We aimed to assess anesthesia capacity in Madagascar as part of the development of a Ministry of Health national surgical plan. METHODS: As part of a nationwide surgical safety quality improvement project, we surveyed 19 of 22 regional hospitals, representing surgical facilities caring for 75% of the total population. The assessment was divided into 3 areas: anesthesia workforce density, infrastructure and equipment, and medications...
June 2017: Anesthesia and Analgesia
https://www.readbyqxmd.com/read/28525505/preoperative-process-quality-improvement-value-is-in-the-eye-of-the-beholder
#20
Angela F Edwards, BobbieJean Sweitzer
No abstract text is available yet for this article.
June 2017: Anesthesia and Analgesia
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