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https://www.readbyqxmd.com/read/28093812/factors-predicting-incidence-of-post-operative-delirium-in-older-people-following-hip-fracture-surgery-a-systematic-review-and-meta-analysis
#1
REVIEW
T O Smith, A Cooper, G Peryer, R Griffiths, C Fox, J Cross
OBJECTIVE: Delirium is one of the most common complications following hip fracture surgery in older people. This study identified pre- and peri-operative factors associated with the development of post-operative delirium following hip fracture surgery. METHODS: Published and unpublished literature were searched to identify all evidence reporting variables on patient characteristics, on-admission, intra-operative and post-operative management assessing incident delirium in older people following hip fracture surgery...
January 17, 2017: International Journal of Geriatric Psychiatry
https://www.readbyqxmd.com/read/28077671/impact-of-long-term-care-facility-residence-on-the-antibiotic-resistance-of-urinary-tract-escherichia-coli-and-klebsiella
#2
Alicia Rosello, Andrew C Hayward, Susan Hopkins, Carolyne Horner, Dean Ironmonger, Peter M Hawkey, Sarah R Deeny
BACKGROUND: Long-term care facilities (LTCFs) are thought to be important reservoirs of antimicrobial-resistant (AMR) bacteria; however, there is no routine surveillance of resistance in LTCF residents, or large population-based studies comparing AMR in LTCFs with the community, so the relative burden of AMR in LTCFs remains unknown. OBJECTIVES: To compare the frequency of antibiotic resistance of urinary tract bacteria from residents of LTCFs for the elderly and adults aged 70 years or older living in the community...
January 10, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28065334/inappropriate-urinary-catheter-reinsertion-in-hospitalized-older-patients
#3
Fang-Wen Hu, Chuan-Hsiu Tsai, Huey-Shyan Lin, Ching-Huey Chen, Chia-Ming Chang
BACKGROUND: We investigated the incidence and rationale for inappropriate reinsertion of urinary catheters and elucidated whether reinsertion is an independent predictor of adverse outcomes. METHODS: A longitudinal study was adopted. Patients aged ≥65 years with urinary catheters placed within 24 hours of hospitalization were enrolled. Data collection, including demographic variables and health conditions, was conducted within 48 hours after admission. Patients with catheters in place were followed-up every day...
January 1, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/28029393/urinary-uromodulin-and-risk-of-urinary-tract-infections-the%C3%A2-cardiovascular-health-study
#4
Pranav S Garimella, Traci M Bartz, Joachim H Ix, Michel Chonchol, Michael G Shlipak, Prasad Devarajan, Michael R Bennett, Mark J Sarnak
BACKGROUND: Laboratory studies suggest that urinary uromodulin, the most common protein in the urine of healthy adults, may protect against urinary tract infection (UTI). Epidemiologic studies evaluating this relationship in humans are lacking. STUDY DESIGN: Prospective longitudinal cohort study. SETTING & PARTICIPANTS: 953 participants enrolled in the Cardiovascular Health Study. PREDICTOR: Uromodulin assayed using enzyme-linked immunosorbent assay in spot urine samples...
October 28, 2016: American Journal of Kidney Diseases: the Official Journal of the National Kidney Foundation
https://www.readbyqxmd.com/read/28007308/a-point-prevalence-survey-of-healthcare-associated-infection-in-fifty-two-chinese-hospitals
#5
Y Chen, J Y Zhao, X Shan, X L Han, S G Tian, F Y Chen, X T Su, Y S Sun, L Y Huang, L Han
BACKGROUND: Healthcare-associated infection (HCAI) represents a major problem for patient safety worldwide. AIM: To demonstrate the prevalence, causative agents, and risk factors for HCAI in Chinese hospitals. METHODS: A one-day point-prevalence survey was conducted in 52 Chinese hospitals between October 2014 and March 2015. A web-based software system was developed for data entry and management. FINDINGS: Among 53,939 patients surveyed, the prevalence of patients with at least one HCAI was 3...
January 2017: Journal of Hospital Infection
https://www.readbyqxmd.com/read/28000024/current-practice-patterns-for-management-of-vulvodynia-in-the-united-states
#6
Lannah L Lua, Yvette Hollette, Prathamesh Parm, Gayle Allenback, Vani Dandolu
PURPOSE: To evaluate the current practice patterns for the management of vulvodynia in the United States (US) and to estimate healthcare costs related to this condition. METHODS: Truven MarketScan Commercial Claims and Encounters databases for years 2009-2013 were utilized for analysis. The study cohort included women, 18 years or older, with a diagnosis of vulvodynia (ICD-9 625.70), who had been continuously enrolled for 360 days from the date of diagnosis. Measures included the most common prescriptions, primary procedures, associated diagnoses, as well as net healthcare costs...
December 20, 2016: Archives of Gynecology and Obstetrics
https://www.readbyqxmd.com/read/27999024/does-moderate-renal-impairment-affect-clinical-outcomes-in-complicated-intra-abdominal-and-complicated-urinary-tract-infections-analysis-of-two-randomized-controlled-trials-with-ceftolozane-tazobactam
#7
Ravina Kullar, Florian M Wagenlehner, Myra W Popejoy, Jianmin Long, Brian Yu, Ellie J C Goldstein
OBJECTIVES: For reasons not well understood, antibacterials can yield lower cure rates in renally impaired patients. We explored this subject for the novel antibacterial ceftolozane/tazobactam. METHODS: ASPECT-complicated intra-abdominal infections (cIAIs) and ASPECT-complicated urinary tract infections (cUTIs) were randomized, double-blinded clinical trials. Analyses in moderate [creatinine clearance (CLCR) 30-50 mL/min] and mild/no (CLCR > 50 mL/min) renal impairment (RI) patients were pre-specified as exploratory endpoints in the statistical analysis plans...
December 20, 2016: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/27997467/functional-outcomes-of-operative-management-of-scapula-fractures-in-a-geriatric-cohort
#8
Peter A Cole, Jeffrey A Gilbertson, Peter A Cole
OBJECTIVES: To analyze functional outcomes, motion, and strength in patients 65 years of age and older who underwent operative management of a scapula fracture. DESIGN: Retrospective review of prospective database. SETTING: A single level-1 teaching trauma center. PATIENTS/PARTICIPANTS: Two hundred fifty patients with scapula fractures were operated between January 2002 and March 2014. A review identified 16 geriatric patients 65 years of age and older...
January 2017: Journal of Orthopaedic Trauma
https://www.readbyqxmd.com/read/27982485/urinary-incontinence-and-its-management-in-patients-aged-65-and-older-in-orthopaedic-care-what-nursing-and-rehabilitation-staff-know-and-do
#9
Maria Hälleberg Nyman, Henrietta Forsman, Joan Ostaszkiewicz, Ami Hommel, Ann Catrine Eldh
AIMS AND OBJECTIVES: To describe what nursing and rehabilitation staff know and do with regards to urinary incontinence and risk of urinary incontinence in patients 65 years or older undergoing hip surgery. BACKGROUND: Urinary incontinence is a common but often neglected issue for older people. Despite the existence of evidence-based guidelines on how to assess, manage and prevent UI, there are indications that these guidelines are not applied in hospital care. DESIGN: A qualitative study with descriptive design was conducted in two orthopaedic units...
December 16, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27979481/postoperative-delirium-is-associated-with-increased-intensive-care-unit-and-hospital-length-of-stays-after-liver-transplantation
#10
Bishwajit Bhattacharya, Adrian Maung, Kimberly Barre, Linda Maerz, Manuel I Rodriguez-Davalos, Michael Schilsky, David C Mulligan, Kimberly A Davis
BACKGROUND: Delirium is increasingly recognized as a common and important postoperative complication that significantly hinders surgical recovery. However, there is a paucity of data examining the incidence and impact of delirium after liver transplantation. METHODS: Retrospective case series in a tertiary care center examining all (n = 144) adult patients who underwent liver transplantation during a 6-y period. RESULTS: Delirium occurred in 25% of the patients with an average duration of 4...
January 2017: Journal of Surgical Research
https://www.readbyqxmd.com/read/27960211/the-modern-diagnostic-approach-to-community-acquired-pneumonia-in-adults
#11
James D Chalmers
Respiratory tract infections, the majority of which are community acquired, are among the leading causes of death worldwide and a leading indication for hospital admission. The burden of disease demonstrates a "U"-shaped distribution, primarily affecting young children as the immune system matures, and older adults as the process of immunosenescence and accumulation of comorbidities leads to increased susceptibility to infection. Diagnosis of community-acquired pneumonia (CAP) is traditionally based on demonstration of a new infiltrate on a chest radiograph in a patient presenting with an acute respiratory illness or sepsis...
December 2016: Seminars in Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27940667/management-and-outcomes-of-previously-healthy-full-term-febrile-infants-ages-7-to-90-days
#12
Tara L Greenhow, Yun-Yi Hung, Robert H Pantell
BACKGROUND: There is considerable variation in the approach to infants presenting to the emergency department and outpatient clinics with fever without a source. We set out to describe the current clinical practice regarding culture acquisition on febrile young infants and review the outcomes of infants with and without cultures obtained. METHODS: This study analyzed Kaiser Permanente Northern California's electronic medical record to identify all febrile, full term, previously healthy infants born between July 1, 2010, and June 30, 2013, presenting for care between 7 and 90 days of age...
December 2016: Pediatrics
https://www.readbyqxmd.com/read/27929709/safety-of-buprenorphine-transdermal-system-in-the-management-of-pain-in-older-adults
#13
Joseph V Pergolizzi, Robert B Raffa, Zachary Marcum, Salvatore Colucci, Steven R Ripa
OBJECTIVES: To evaluate whether buprenorphine transdermal system (BTDS; Butrans®) is an option for the treatment of chronic pain in older adults. METHODS: This retrospective analysis of 16 placebo- and active-controlled and uncontrolled studies (N = 6566) evaluated the safety and tolerability profile in patients exposed to BTDS and compared the safety profiles associated with BTDS treatment in older patients ≥ 65 years of age (65 to 98 years) and younger patients < 65 years of age (18 to 64 years)...
December 26, 2016: Postgraduate Medicine
https://www.readbyqxmd.com/read/27929243/epididymitis-an-overview
#14
John R McConaghy, Bethany Panchal
Inflammation of the epididymis, or epididymitis, is commonly seen in the outpatient setting. Etiology and treatment are based on patient age and the likely causative organisms. Epididymitis presents as the gradual onset of posterior scrotal pain that may be accompanied by urinary symptoms such as dysuria and urinary frequency. Physical findings include a swollen and tender epididymis with the testis in an anatomically normal position. Although the etiology is largely unknown, reflux of urine into the ejaculatory ducts is considered the most common cause of epididymitis in children younger than 14 years...
November 1, 2016: American Family Physician
https://www.readbyqxmd.com/read/27923346/comparison-of-gram-negative-and-gram-positive-hematogenous-pyogenic-spondylodiscitis-clinical-characteristics-and-outcomes-of-treatment
#15
Ching-Yu Lee, Meng-Huang Wu, Chin-Chang Cheng, Tsung-Jen Huang, Tsung-Yu Huang, Chien-Yin Lee, Jou-Chen Huang, Yen-Yao Li
BACKGROUND: To the best of our knowledge, no study has compared gram-negative bacillary hematogenous pyogenic spondylodiscitis (GNB-HPS) with gram-positive coccal hematogenous pyogenic spondylodiscitis (GPC-HPS) regarding their clinical characteristics and outcomes. METHODS: From January 2003 to January 2013, 54 patients who underwent combined antibiotic and surgical therapy in the treatment of hematogenous pyogenic spondylodiscitis were included. RESULTS: Compared with 37 GPC-HPS patients, the 17 GNB-HPS patients were more often found to be older individuals, a history of cancer, and a previous history of symptomatic urinary tract infection...
December 6, 2016: BMC Infectious Diseases
https://www.readbyqxmd.com/read/27920972/potentially-preventable-hospitalizations-for-acute-and-chronic-conditions-in-alaska-2010-2012
#16
Prabhu P Gounder, Sara M Seeman, Robert C Holman, Alice Rarig, Mary K McEwen, Claudia A Steiner, Michael L Bartholomew, Thomas W Hennessy
OBJECTIVE: The U.S. Agency for Healthcare Research and Quality's Prevention Quality Indicators comprise acute and chronic conditions for which hospitalization can be potentially prevented by high-quality ambulatory care. The Healthy Alaska 2020 initiative (HA2020) targeted reducing potentially preventable hospitalizations (PPH) for acute and chronic conditions among its health indicators. We estimated the PPH rate for adults aged ≥ 18 years in Alaska during 2010-2012. METHODS: We conducted a cross-sectional analysis of state-wide hospital discharge data obtained from the Healthcare Cost and Utilization Project and the Indian Health Service...
December 2016: Preventive Medicine Reports
https://www.readbyqxmd.com/read/27912035/failure-to-rescue-after-infectious-complications-in-a-statewide-trauma-system
#17
Elinore J Kaufman, Emily Earl-Royal, Philip S Barie, Daniel N Holena
BACKGROUND: The failure to rescue (FTR) rate, the rate of death after a complication, measures a center's ability to identify and manage complications by "rescuing" vulnerable patients. Infectious complications are common after trauma, but risk factors for death after infection are not established. We hypothesized that risk factors would differ for FTR after infectious complications, development of infections, and for development of and death after non-infectious complications. PATIENTS AND METHODS: We analyzed trauma registry data for adult patients admitted to all 30 level I and II Pennsylvania trauma centers, 2011-2014...
December 2, 2016: Surgical Infections
https://www.readbyqxmd.com/read/27898998/nutritional-supplementation-for-hip-fracture-aftercare-in-older-people
#18
REVIEW
Alison Avenell, Toby O Smith, James P Curtain, Jenson Cs Mak, Phyo K Myint
BACKGROUND: Older people with hip fractures are often malnourished at the time of fracture, and subsequently have poor food intake. This is an update of a Cochrane review first published in 2000, and previously updated in 2010. OBJECTIVES: To review the effects (benefits and harms) of nutritional interventions in older people recovering from hip fracture. SEARCH METHODS: We searched the Cochrane Bone, Joint and Muscle Trauma Group Specialised Register, CENTRAL, MEDLINE, MEDLINE In-Process & Other Non-Indexed Citations, Embase, CAB Abstracts, CINAHL, trial registers and reference lists...
November 30, 2016: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/27898524/uromodulin-in-kidney-health-and-disease
#19
Pranav S Garimella, Mark J Sarnak
PURPOSE OF REVIEW: Although uromodulin or Tamm-Horsfall protein was discovered over 60 years ago, its functional role in humans remains unclear. This review highlights new studies elucidating the clinical correlates of uromodulin, its association with kidney function decline, nephrolithiasis and urinary host defense. RECENT FINDINGS: Uromodulin is evolutionarily conserved and has multiple functional roles. In large population studies, higher levels of uromodulin are associated with higher estimated glomerular filtration rate (eGFR) and kidney size, possibly indicating greater kidney functional reserve...
November 24, 2016: Current Opinion in Nephrology and Hypertension
https://www.readbyqxmd.com/read/27889591/adverse-events-and-treatment-discontinuations-of-antimuscarinics-for-the-treatment-of-overactive-bladder-in-older-adults-a-systematic-review-and-meta-analysis
#20
REVIEW
Scott Martin Vouri, Clark D Kebodeaux, Paul M Stranges, Besu F Teshome
INTRODUCTION: Antimuscarinics should be used with caution in older adults with overactive bladder (OAB) due to anticholinergic adverse events (AEs). Systematic reviews and meta-analyses (SRMAs) have analyzed safety-related outcomes but have not specified risk in the elderly, the population at highest risk for AEs. The aim of this review is to explore and evaluate AEs and treatment discontinuations in adults 65 or older taking antimuscarinics for OAB. METHODS: Keywords were searched in MEDLINE, EMBASE, SCOPUS, and Cochrane Central Register for Controlled Trials...
March 2017: Archives of Gerontology and Geriatrics
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