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https://www.readbyqxmd.com/read/28651296/early-discharge-hospital-at-home
#1
REVIEW
Daniela C Gonçalves-Bradley, Steve Iliffe, Helen A Doll, Joanna Broad, John Gladman, Peter Langhorne, Suzanne H Richards, Sasha Shepperd
BACKGROUND: Early discharge hospital at home is a service that provides active treatment by healthcare professionals in the patient's home for a condition that otherwise would require acute hospital inpatient care. This is an update of a Cochrane review. OBJECTIVES: To determine the effectiveness and cost of managing patients with early discharge hospital at home compared with inpatient hospital care. SEARCH METHODS: We searched the following databases to 9 January 2017: the Cochrane Effective Practice and Organisation of Care Group (EPOC) register, Cochrane Central Register of Controlled Trials (CENTRAL), MEDLINE, Embase, CINAHL, and EconLit...
June 26, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28651219/a-20-year-multi-followup-longitudinal-study-assessing-whether-antipsychotic-medications-contribute-to-work-functioning-in-schizophrenia
#2
Martin Harrow, Thomas H Jobe, Robert N Faull, Jie Yang
To assess the long-term effectiveness of antipsychotic medications in facilitating work functioning in patients with schizophrenia we conducted longitudinal multifollowup research on 139 initially psychotic patients. The 70 patients with schizophrenia and 69 initially psychotic mood disordered control patients were followed up 6 times over 20 years. We compared the influence on work functioning of patients with schizophrenia continuously prescribed antipsychotics with patients with schizophrenia not prescribed antipsychotics, using statistical controls for inter-subject differences...
June 22, 2017: Psychiatry Research
https://www.readbyqxmd.com/read/28651010/macrophages-but-not-neutrophils-are-critical-for-proliferation-of-burkholderia-cenocepacia-and-ensuing-host-damaging-inflammation
#3
Jennifer Mesureur, Joana R Feliciano, Nelly Wagner, Margarida C Gomes, Lili Zhang, Monica Blanco-Gonzalez, Michiel van der Vaart, David O'Callaghan, Annemarie H Meijer, Annette C Vergunst
Bacteria of the Burkholderia cepacia complex (Bcc) can cause devastating pulmonary infections in cystic fibrosis (CF) patients, yet the precise mechanisms underlying inflammation, recurrent exacerbations and transition from chronic stages to acute infection and septicemia are not known. Bcc bacteria are generally believed to have a predominant extracellular biofilm life style in infected CF lungs, similar to Pseudomonas aeruginosa, but this has been challenged by clinical observations which show Bcc bacteria predominantly in alveolar macrophages...
June 26, 2017: PLoS Pathogens
https://www.readbyqxmd.com/read/28650872/barriers-and-facilitators-to-implementing-a-change-initiative-in-long-term-care-using-the-interact%C3%A2-quality-improvement-program
#4
Ruth M Tappen, David G Wolf, Zahra Rahemi, Gabriella Engstrom, Carolina Rojido, Jill M Shutes, Joseph G Ouslander
Implementation of major organizational change initiatives presents a challenge for long-term care leadership. Implementation of the INTERACT® (Interventions to Reduce Acute Care Transfers) quality improvement program, designed to improve the management of acute changes in condition and reduce unnecessary emergency department visits and hospitalizations of nursing home residents, serves as an example to illustrate the facilitators and barriers to major change in long-term care. As part of a larger study of the impact of INTERACT® on rates of emergency department visits and hospitalizations, staff of 71 nursing homes were called monthly to follow-up on their progress and discuss successful facilitating strategies and any challenges and barriers they encountered during the yearlong implementation period...
June 23, 2017: Health Care Manager
https://www.readbyqxmd.com/read/28650745/longer-duration-antimicrobial-therapy-does-not-prevent-treatment-failure-in-high-risk-patients-with-complicated-intra-abdominal-infections
#5
Taryn E Hassinger, Christopher A Guidry, Ori D Rotstein, Therese M Duane, Heather L Evans, Charles H Cook, Patrick J O'neill, John E Mazuski, Reza Askari, Lena M Napolitano, Nicholas Namias, Preston R Miller, E Patchen Dellinger, Raul Coimbra, Christine S Cocanour, Kaysie L Banton, Joseph Cuschieri, Kimberley Popovsky, Robert G Sawyer
BACKGROUND: Recent studies have suggested the length of treatment of intra-abdominal infections (IAIs) can be shortened without detrimental effects on patient outcomes. However, data from high-risk patient populations are lacking. We hypothesized that patients at high risk for treatment failure will benefit from a longer course of antimicrobial therapy. METHODS: Patients enrolled in the Study to Optimize Peritoneal Infection Therapy (STOP-IT) trial were evaluated retrospectively to identify risk factors associated with treatment failure, which was defined as the composite outcome of recurrent IAI, surgical site infection, or death...
June 26, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28650412/pressure-injury-knowledge-in-critical-care-nurses
#6
Donna M Miller, Lisa Neelon, Kathleen Kish-Smith, Laura Whitney, Christopher J Burant
PURPOSE: The purpose of this study was to identify pressure injury knowledge in critical care nurses related to prevention and staging following multimodal education initiatives. DESIGN: Postintervention descriptive study. SETTING AND SAMPLE: The sample comprised 32 RNs employed in medical intensive care/coronary intensive care or surgical intensive care units. The study setting was a 237-bed Veterans Affairs acute care hospital in the Midwestern United States...
June 21, 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28650398/predictors-of-functional-change-in-a-skilled-nursing-facility-population
#7
Allison M Gustavson, Jason R Falvey, Jeri E Forster, Jennifer E Stevens-Lapsley
BACKGROUND AND PURPOSE: Inability to obtain sufficient gains in function during a skilled nursing facility (SNF) stay impacts patients' functional trajectories and susceptibility to adverse events. The purpose of this study was to identify predictors of functional change in patients temporarily residing in an SNF following hospitalization. METHODS: One hundred forty patients admitted to a single SNF from the hospital who had both evaluation and discharge measures of physical function documented were included...
June 21, 2017: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/28650394/visceral-adiposity-predicts-severity-of-acute-pancreatitis
#8
Ashwinee Natu, Tyler Stevens, Lorna Kang, Scott Yasinow, Emad Mansoor, Rocio Lopez, Brooke Glessing, Erick Remer, Tyler Richards, Amit Gupta, Amitabh Chak, Peter J W Lee
OBJECTIVES: The aim of this study was to determine the association of visceral adiposity with severe outcomes in acute pancreatitis (AP). METHODS: This retrospective study included consecutive patients with AP admitted to a tertiary care hospital between January 2010 and January 2015 who underwent a computed tomography scan. The visceral adipose tissue (VAT) volume was estimated using the method of Linder and colleagues. Multivariable logistic regression analysis was conducted to assess VAT as a predictor of severe AP compared with other validated predictors of severity...
June 22, 2017: Pancreas
https://www.readbyqxmd.com/read/28650331/expression-of-th17-and-cd4-cd25-t-regulatory-cells-in-peripheral-blood-of-acute-leukemia-patients-and-their-prognostic-significance
#9
Mingli Xiang, Li Guo, Yan Ma, Yi Li
To discuss the expression of T helper cell 17 (Th17) cells and CD4+ CD25+ Foxp3+ regulatory T cells (Treg) in peripheral blood (PB) of patients with acute leukemia (AL), and to explore the relationship between them and disease prognosis. 40 patients diagnosed with acute leukemia in The First Affiliated Hospital of Zhengzhou University from July 2012 to August 2014 were selected as the observation group. Meanwhile, 40 healthy people were taken as the control group. Flow Cytometry Method (FCM) was used to detect the level of Th17 cells and CD4(+) CD25(+) Foxp3(+) cells in peripheral blood of the two groups, and enzyme-linked immuno sorbent assay (ELISA) method was used to test the level of IL17 and TGF-β in peripheral blood of two groups; reverse transcription-polymerase chain reaction (RT-PCR) was adopted to analyze the mRNA levels of RORγT and Foxp3 in peripheral blood...
March 2017: Pakistan Journal of Pharmaceutical Sciences
https://www.readbyqxmd.com/read/28650078/genetic-diversity-of-human-metapneumovirus-in-hospitalized-children-with-acute-respiratory-infections-in-croatia
#10
M Jagušić, A Slovic, S Ljubin Sternak, G Mlinarić-Galinović, D Forčić
Human metapneumovirus (HMPV) is recognized as a global and frequent cause of acute respiratory tract infections among people of all ages. The objectives of this study were molecular epidemiology and evolutionary analysis of HMPV strains which produced moderate and severe acute respiratory tract infections in children in Croatia during four consecutive seasons (2011-2014). A total of 117 HMPV-positive samples collected from hospitalized paediatric patients presenting with acute respiratory tract infections and tested by direct immunofluorescence assay were first analyzed by amplifying a part of the F gene...
June 26, 2017: Journal of Medical Virology
https://www.readbyqxmd.com/read/28649575/ecmo-in-major-burn-patients-feasibility-and-considerations-when-multiple-modes-of-mechanical-ventilation-fail
#11
Jason D Kennedy, Wesley Thayer, Reuben Beuno, Kelly Kohorst, Avinash B Kumar
BACKGROUND: We report two cases of acute respiratory distress syndrome in burn patients who were successfully managed with good outcomes with extra corporeal membrane oxygenation (ECMO) after failing multiple conventional modes of ventilation, and review the relevant literature. CASE PRESENTATION: The two patients were a 39-year-old male and 53-year-old male with modified Baux Scores of 79 and 78, respectively, with no known inhalation injury. After the initial modified Parkland-based fluid resuscitation and partial escharotomy, both patients developed worsening hypoxemia and acute respiratory distress syndrome...
2017: Burns and trauma
https://www.readbyqxmd.com/read/28649454/methods-guiding-stakeholder-engagement-in-planning-a-pragmatic-study-on-changing-stroke-systems-of-care
#12
Sabina B Gesell, Karen Potvin Klein, Jacqueline Halladay, Janet Prvu Bettger, Janet Freburger, Doyle M Cummings, Barbara J Lutz, Sylvia Coleman, Cheryl Bushnell, Wayne Rosamond, Pamela W Duncan
BACKGROUND: The Comprehensive Post-Acute Stroke Services (COMPASS) Study is one of the first large pragmatic randomized-controlled clinical trials using comparative effectiveness research methods, funded by the Patient-Centered Outcomes Research Institute. In the COMPASS Study, we compare the effectiveness of a patient-centered, transitional care intervention versus usual care for stroke patients discharged home from acute care. Outcomes include stroke patient post-discharge functional status and caregiver strain 90 days after discharge, and hospital readmissions...
April 2017: Journal of clinical and translational science
https://www.readbyqxmd.com/read/28649418/facilitating-access-to-health-research-through-a-participatory-research-register-a-feasibility-study-in-outpatient-clinics
#13
Verity A Leach, John D McGeagh, Ruta Margelyte, Niamh M Redmond, Axel Walther, Sabi Redwood, Richard M Martin, Jenny L Donovan
BACKGROUND: A research register (Reach West) has been established to facilitate recruitment of people and patients to health-related research. We conducted a prospective feasibility study to investigate the practicality of recruiting through outpatient clinics. METHODS: Patients over 18 years of age attending dental, eye or oncology outpatient clinics in an acute hospital in the West of England were provided with the opportunity to participate in Reach West. In Phase I, recruitment packs were handed to clinic attendees who could place completed consent forms in secure drop-box or return them later on-line or by post...
2018: Pilot and Feasibility Studies
https://www.readbyqxmd.com/read/28649089/prognostic-nutritional-index-and-the-risk-of-mortality-in-patients-with-acute-heart-failure
#14
Yu-Lun Cheng, Shih-Hsien Sung, Hao-Min Cheng, Pai-Feng Hsu, Chao-Yu Guo, Wen-Chung Yu, Chen-Huan Chen
BACKGROUND: Nutritional status has been related to clinical outcomes in patients with heart failure. We assessed the association between nutritional status, indexed by prognostic nutritional index (PNI), and survival in patients hospitalized for acute heart failure. METHODS AND RESULTS: A total of 1673 patients (age 76±13 years, 68% men) hospitalized for acute heart failure in a tertiary medical center were analyzed. PNI was calculated as 10×serum albumin (g/dL)+0...
June 25, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28648947/hematopoietic-stem-cell-transplantation-in-the-sultanate-of-oman
#15
REVIEW
Murtadha Al-Khabori, Mohammed Al-Huneini
The Sultanate of Oman is one of the Arabian Gulf countries with a total population of 4,414,051 as of mid 2016, of which 2,427,825 are Omanis. The gross national income per capita was 7327.7 RO (Omani rial; equivalent to US$19,033) in 2014. There are two hematopoietic stem cell transplantation (HSCT) centers in Oman: the Sultan Qaboos University Hospital (SQUH; allogeneic and autologous) and the Royal Hospital (RH; autologous). HSCT activity in Oman started in 1995 at the SQUH center, which had only one bed, and four cases were performed in that year...
June 17, 2017: Hematology/oncology and Stem Cell Therapy
https://www.readbyqxmd.com/read/28648682/a-qualitative-investigation-of-exercise-perceptions-and-experiences-in-people-with-multiple-sclerosis-before-during-and-after-participation-in-a-personally-tailored-exercise-program
#16
Helen Crank, Anouska Carter, Liam Humphreys, Nicky Snowdon, Amanda Daley, Nicola Woodroofe, Basil Sharrack, Jane Petty, John M Saxton
OBJECTIVE: To undertake a qualitative investigation of exercise perceptions and experiences in people with MS (PwMS) before, during and after participation in a personally-tailored program designed to promote long-term maintenance of self-directed exercise. DESIGN: Focus groups and semi-structured telephone interviews. SETTING: University Exercise Science Department close to the recruiting hospital. PARTICIPANTS: PwMS (N=33; aged 47...
June 22, 2017: Archives of Physical Medicine and Rehabilitation
https://www.readbyqxmd.com/read/28648543/seasonal-influenza-vaccine-effectiveness-against-laboratory-confirmed-influenza-hospitalizations-latin-america-2013
#17
Nathalie El Omeiri, Eduardo Azziz-Baumgartner, Mark G Thompson, Wilfrido Clará, Mauricio Cerpa, Rakhee Palekar, Sara Mirza, Alba María Ropero-Álvarez
BACKGROUND: Despite widespread utilization of influenza vaccines, effectiveness (VE) has not been routinely measured in Latin America. METHODS: We used a case test-negative control design to estimate trivalent inactivated influenza VE against laboratory-confirmed influenza among hospitalized children aged 6months-5years and adults aged ≥60years which are age-groups targeted for vaccination. We sought persons with severe acute respiratory infections (SARI), hospitalized at 71 sentinel hospitals in Argentina, Brazil, Chile, Colombia, Costa Rica, El Salvador, Honduras, Panama, and Paraguay during January-December 2013...
June 22, 2017: Vaccine
https://www.readbyqxmd.com/read/28648416/primary-percutaneous-coronary-intervention-for-acute-st-elevation-myocardial-infarction-outcomes-and-determinants-of-outcomes-a-tertiary-care-center-study-from-north-india
#18
Gajendra Dubey, Sunil Kumar Verma, Vinay Kumar Bahl
BACKGROUND: Primary percutaneous coronary intervention (PCI) is the current standard of care for acute ST elevation myocardial infarction (STEMI). Most of the data on primary PCI in acute STEMI is from western countries. We studied the outcomes of primary PCI for acute STEMI at a tertiary care center in North India. METHODS: Consecutive patients undergoing primary PCI for STEMI were prospectively studied during the period from February 2103 to May 2015. The outcomes assessed were all cause in hospital mortality, factors associated with mortality, major adverse cardiac and cerebrovascular event rate (composite of all cause in hospital mortality, non-fatal re infarction and stroke) and procedural complications...
May 2017: Indian Heart Journal
https://www.readbyqxmd.com/read/28648313/cost-of-osteoporotic-fractures-in-singapore
#19
Charmaine Shuyu Ng, Tang Ching Lau, Yu Ko
OBJECTIVES: To estimate the 3-month direct and indirect costs associated with osteoporotic fractures from both the hospital's and patient's perspectives in Singapore and to compare the cost between acute and prevalent osteoporotic fractures. METHODS: Resource use and expenditure data were collected using interviewer-administered questionnaires at baseline and at a 3-month follow-up between July 2013 and January 2014. Estimated osteoporotic fracture-related costs included hospitalizations, accident and emergency room visits, outpatient physician visits, laboratory tests, medications, transportation, health care and community services, special equipment and home/car modifications, and productivity loss...
May 2017: Value in Health Regional Issues
https://www.readbyqxmd.com/read/28648218/innovative-information-technology-powered-population-health-care-management-improves-outcomes-and-reduces-hospital-readmissions-and-emergency-department-visits
#20
Sharon Anderson, Michele Campbell, Donna Mahoney, Ann Kathryn Muther, Janice Nevin, Patricia Resnik, Tabassum Salam, Terri Steinberg
BACKGROUND: Patients with chronic conditions are often the most frequent users of health care. Moreover, adapting to developments in one's illness, understanding how to self-manage a chronic illness, and sharing information between primary care and specialty providers, can be a full-time job for someone with a chronic illness. In response to these challenges, Christiana Care Health System (Wilmington, Delaware) developed Care Link, an information technology (IT)-enhanced care management support to enable populations of patients to achieve better clinical outcomes at lower cost...
July 2017: Joint Commission Journal on Quality and Patient Safety
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