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Jason Suh, Amishi Desai, Anish Desai, Josephine Dela Cruz, Anusiyanthan Mariampillai, Alexander Hindenburg
Venous thromboembolism (VTE) remains the number one preventable cause of hospital acquired mortality and morbidity. Each year, more than 12 million patients are at risk for VTE. The delivery of appropriate and timely VTE prophylaxis is still suboptimal in many healthcare institutions and can lead to increased readmissions, morbidity, as well as costs. To clarify this issue further, we performed a retrospective case control study at our institution to determine if poor adherence to the VTE prophylaxis guidelines could lead to an increase in VTE events...
October 17, 2016: Journal of Thrombosis and Thrombolysis
Alejandro Suarez De La Rica, Fernando Gilsanz, Emilio Maseda
Since the American College of Chest Physicians (ACCP) and the Society of Critical care Medicine (SCCM) published the first consensus definition of syndromes related to sepsis in 1992, the knowledge of epidemiology of sepsis has clearly improved, although no prospective studies have been performed to analyse the incidence of sepsis in general population. There are differences in epidemiologic trends in sepsis between western countries and low-income and middle-income countries. In the United States (US), most of epidemiologic studies have been based on large, administrative databases, reporting an increase in the incidence of severe sepsis over years...
September 2016: Annals of Translational Medicine
S B Wilhelms, S M Walther, F Huss, F Sjöberg
BACKGROUND: Different International Classification of Diseases (ICD)-based code abstraction strategies have been used when studying the epidemiology of severe sepsis. The aim of this study was to compare three previously used ICD code abstraction strategies to the American College of Chest Physicians/Society of Critical Care Medicine (ACCP/SCCM) consensus criteria for severe sepsis, in a setting of intensive care patients. METHODS: All patients (≥ 18 years of age) with severe sepsis according to the ACCP/SCCM criteria registered in the Swedish Intensive Care Registry (2005-2009) were included in the study...
October 4, 2016: Acta Anaesthesiologica Scandinavica
Jyoti Savla, Zhe Wang, Karen A Roberto, Rosemary Blieszner
Introduction: An emerging perspective of dyadic coping with chronic illness argues that concordance in the appraisal of illness is crucial for collaborative attempts at seeking information, making treatment decisions, and planning for long-term management of the illness and psychological and physical adjustments of both the care provider and care recipient. The present study examined whether persons with mild cognitive impairment (PwMCIs) and their family care partners (CPs) exhibited concordance in their awareness of deficits in the PwMCIs...
September 29, 2016: Families, Systems & Health: the Journal of Collaborative Family Healthcare
Negib Geahchan, Melkart Basile, Maroon Tohmeh
BACKGROUND: Venous thromboembolism (VTE) is a major health care problem resulting in significant mortality, morbidity and increase in medical expenses. Patients with malignant diseases represent a high risk population for VTE. The American College of Chest Physicians (ACCP) proposed, since 1986, prophylaxis guidelines that are unequally respected in surgical practice. METHODS: DIONYS is a multinational, longitudinal and non-interventional registry including patients having undergone abdominal or pelvic surgery for cancer in Latin America, Africa and the Middle East...
2016: SpringerPlus
Peter J Kahrilas, Kenneth W Altman, Anne B Chang, Stephen K Field, Susan M Harding, Andrew P Lane, Kaiser Lim, Lorcan McGarvey, Jaclyn Smith, Richard S Irwin
BACKGROUND: We updated the 2006 ACCP clinical practice guidelines for management of reflux-cough syndrome. METHODS: Two PICO questions were addressed by systematic review: 1) can therapy for gastroesophageal reflux improve or eliminate cough in adults with chronic and persistently troublesome cough? and 2) are there minimal clinical criteria to guide practice in determining that chronic cough is likely to respond to therapy for gastroesophageal reflux? RESULTS: We found no high quality studies pertinent to either question...
September 7, 2016: Chest
A C Brisset, A Ferrández, M Krause, S Rathbun, R Marlar, W Korte
BACKGROUND: Unfractionated heparin (UFH) is still a commonly used anticoagulant for prevention and treatment of thromboembolism in a variety of situations. Increasingly, chromogenic anti-Xa assays are used for UFH monitoring given the high variability of the activated partial thromboplastin time (aPTT) in this setting. On the other hand, and despite the known variability, the aPTT test remains the most frequently used monitoring tool in UFH therapy due to its broad availability, lower costs, and wide acceptance...
September 1, 2016: Journal of Thrombosis and Haemostasis: JTH
Letizia Marconi, Laura Carrozzi, Ferruccio Aquilini, Alessandro Celi, Francesco Pistelli, Antonio Palla
Benefits and harms of long-term anticoagulant therapy (AT) after acute pulmonary embolism (PE) are poorly known. The aim of this study was to investigate the outcome of patients with PE treated with AT for 5 years according to American College of Chest Physicians (ACCP) guidelines.Patients with both unprovoked and secondary PE were consecutively enrolled in a "real life" study. After a 12-month AT, they continued or stopped the treatment according to ACCP guidelines, and were followed-up for 5 years. Outcomes were all-cause mortality, recurrence, and fatal recurrence under AT...
August 2016: Medicine (Baltimore)
Gian Alberto Soardi, Simone Perandini, Anna Rita Larici, Annemilia Del Ciello, Giovanna Rizzardi, Antonio Solazzo, Laura Mancino, Marco Bernhart, Massimiliano Motton, Stefania Montemezzi
OBJECTIVES: To provide multicentre external validation of the Bayesian Inference Malignancy Calculator (BIMC) model by assessing diagnostic accuracy in a cohort of solitary pulmonary nodules (SPNs) collected in a clinic-based setting. To assess model impact on SPN decision analysis and to compare findings with those obtained via the Mayo Clinic model. METHODS: Clinical and imaging data were retrospectively collected from 200 patients from three centres. Accuracy was assessed by means of receiver-operating characteristic (ROC) areas under the curve (AUCs)...
August 23, 2016: European Radiology
Alexander A Kon, Eric K Shepard, Nneka O Sederstrom, Sandra M Swoboda, Mary Faith Marshall, Barbara Birriel, Fred Rincon
OBJECTIVES: The Society of Critical Care Medicine and four other major critical care organizations have endorsed a seven-step process to resolve disagreements about potentially inappropriate treatments. The multiorganization statement (entitled: An official ATS/AACN/ACCP/ESICM/SCCM Policy Statement: Responding to Requests for Potentially Inappropriate Treatments in Intensive Care Units) provides examples of potentially inappropriate treatments; however, no clear definition is provided...
September 2016: Critical Care Medicine
Susan M Tarlo, Kenneth W Altman, John Oppenheimer, Kaiser Lim, Anne Vertigan, David Prezant, Richard S Irwin
BACKGROUND: In response to occupational and environmental exposures, cough can be an isolated symptom reflecting exposure to an irritant with little physiological consequence, or it can be a manifestation of more significant disease. This document reviews occupational and environmental contributions to chronic cough in adults, focusing on aspects not previously covered in the 2006 ACCP Cough Guideline or our more recent systematic review, and suggests an approach to investigation of these factors when suspected...
October 2016: Chest
Hui Yang, Xiangli Cui, Zhuo Ma, Lihong Liu
A better dosing strategy can improve clinical outcomes for patients. We systematically reviewed the literatures to determine whether any clinical benefits exist for piperacillin/tazobactam by extended or continuous infusion. Methods - A search of PubMed, Web of Science, ProQuest, ScienceDirect, Cochrane, Embase and related ICAAC and ACCP conferences were conducted up to September 5, 2015. Randomized controlled and observational studies that compared extended or continuous infusion with conventional intermittent infusion of piperacillin/tazobactam were identified from the databases above and analyzed...
April 2016: Journal of Pharmacy & Pharmaceutical Sciences: a Publication of the Canadian Society for Pharmaceutical Sciences
Fahri Gurkan Yesil, Mustafa Kurkluoglu, Adem Guler, Mehmet Ali Sahin, Bilgehan Savas Oz
No abstract text is available yet for this article.
June 2016: Kardiochirurgia i Torakochirurgia Polska, Polish Journal of Cardio-Thoracic Surgery
Noam Oz, Danny Alon, Chava Chezar-Azerrad, Lisa Cooper, Yochai Levi, Shmuel Fuchs, Gideon Y Stein
BACKGROUND: Prophylaxis for hospitalized venous-thromboembolic events (VTEs) is frequently underutilized, in part due to lack of a simple risk assessment model (RAM). OBJECTIVES: To compare patient selection and administration of VTE prophylaxis according to the American College of Chest Physicians (ACCP) 2008 guidelines versus the newer 2012 guidelines, and assess the feasibility of developing simpler local RAMs. METHODS: We conducted a prospective assessment of VTE risk among 300 unselected consecutive patients admitted to a medical hospital ward, using the 2008 and 2012 ACCP guidelines...
June 2016: Israel Medical Association Journal: IMAJ
R J Jolley, D W Yergens, H Quan, C J Doig
No abstract text is available yet for this article.
December 2015: Intensive Care Medicine Experimental
Amber Randel
No abstract text is available yet for this article.
June 1, 2016: American Family Physician
T Edwards, H Al-Najjar, P Crosbie, J Martin, R Booton, M Evison
No abstract text is available yet for this article.
April 2016: Journal of Thoracic Oncology
Chee K Phua, Wen Y Sim, Kuan Sen Tee, Sennen J W Lew, Albert Y H Lim, Dessmon Y H Tai, Soon Keng Goh, Ai Ching Kor, Alan W K Ng, John Abisheganaden, Akash Verma
BACKGROUND: American College of Chest Physicians (ACCP) provides guidelines to manage pulmonary nodules. Pulmonary nodules however can be malignant or benign. Similar incidence of tuberculosis (TB) and lung cancer in Asian countries raises concern over the relevance of suggested guidelines in Asian population. There is little data on the pattern of clinical practice in the management of pulmonary nodules in Asian country (Singapore). Our study describes the current pattern of clinical practice in this area highlighting the variation in practice and discussing the potential reasons...
May 2016: Journal of Thoracic Disease
Luján Iavecchia, Ahmad Safiya, David Salat, Mònica Sabaté, Montse Bosch, Alfons Biarnés, Angels Camps, Dolors Castellà, Pilar Lalueza, Verònica Pons, Jordi Teixidor, Maria M Villar, Antònia Agustí
This study aimed to describe the impact of implementing a protocol on the perioperative management of patients admitted for hip fracture treated with anti-thrombotics. A protocol was designed based on recommendations from the American College of Chest Physicians (ACCP). After its implementation (May 2012), information on anti-thrombotic management was collected from admission to three months after surgery in retrospective (October 2011-March 2012) and prospective (October 2012-March 2013) cohorts. Patients' thromboembolic risk was classified into high, moderate or low according to the ACCP categories...
May 6, 2016: Basic & Clinical Pharmacology & Toxicology
Tiffany Chan, Michael S Bleszynski, Andrzej K Buczkowski
INTRODUCTION: Evaluation of the effectiveness of care and clinical outcomes in critically ill patients is dependent on predictive scoring models that calculate measures of disease severity and an associated likelihood of mortality. The APACHE scoring system is a logistic regression model incorporating physiologic and laboratory parameters. APACHE-IV is the most updated scoring system for ICU mortality prediction. However, APACHE scores may not accurately predict mortality in patients who require surgery for abdominal sepsis, whose trajectory is modulated by source control procedures...
March 2016: Journal of Clinical and Diagnostic Research: JCDR
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