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Stlukes

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59 papers 100 to 500 followers
By St. Lukes Medical Library Chesterfield
https://www.readbyqxmd.com/read/28580725/effects-of-acute-postacute-continuity-on-community-discharge-and-30-day-rehospitalization-following-inpatient-rehabilitation
#1
James E Graham, Janet Prvu Bettger, Addie Middleton, Heidi Spratt, Gulshan Sharma, Kenneth J Ottenbacher
OBJECTIVE: To examine the effects of facility-level acute-postacute continuity on probability of community discharge and 30-day rehospitalization following inpatient rehabilitation. DATA SOURCES: We used national Medicare enrollment, claims, and assessment data to study 541,097 patients discharged from 1,156 inpatient rehabilitation facilities (IRFs) in 2010-2011. STUDY DESIGN: We calculated facility-level continuity as the percentages of an IRF's patients admitted from each contributing acute care hospital...
October 2017: Health Services Research
https://www.readbyqxmd.com/read/28920751/distress-due-to-prognostic-uncertainty-in-palliative-care-frequency-distribution-and-outcomes-among-hospitalized-patients-with-advanced-cancer
#2
Robert Gramling, Susan Stanek, Paul K J Han, Paul Duberstein, Tim E Quill, Jennifer S Temel, Stewart C Alexander, Wendy G Anderson, Susan Ladwig, Sally A Norton
BACKGROUND: Prognostic uncertainty is common in advanced cancer and frequently addressed during palliative care consultation, yet we know little about its impact on quality of life (QOL). OBJECTIVE: We describe the prevalence and distribution of distress due to prognostic uncertainty among hospitalized patients with advanced cancer before palliative care consultation. We evaluate the association between this type of distress and overall QOL before and after palliative care consultation...
September 18, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28923761/surgical-treatment-of-obstructive-sleep-apnea-on-cardiovascular-outcomes-a-systematic-review
#3
Tyler R Halle, Melissa S Oh, Nancy A Collop, Arshed A Quyyumi, Donald L Bliwise, Raj C Dedhia
BACKGROUND: Obstructive sleep apnea (OSA) is an increasingly prevalent clinical problem with significant effects on quality of life and cardiovascular risk. Surgical therapy represents an important treatment for those unable to use positive airway pressure. This systematic review examines the available cardiovascular risk reduction data for surgical treatment of OSA. METHODS: A comprehensive literature search was performed. Articles were included if they met the following criteria: (1) adults >18 years (2) OSA diagnosed by sleep study; (3) surgical intervention performed for OSA; (4) one or more physical or biochemical cardiovascular and/or cerebrovascular variables was measured pre-operatively and at ≥14 days postoperatively...
September 15, 2017: Chest
https://www.readbyqxmd.com/read/28925664/preventing-falls-in-older-persons
#4
Lainie Van Voast Moncada, L Glen Mire
The American Geriatrics Society and British Geriatrics Society recommend that all adults older than 65 years be screened annually for a history of falls or balance impairment. The U.S. Preventive Services Task Force and American Academy of Family Physicians recommend exercise or physical therapy and vitamin D supplementation to prevent falls in community-dwelling older adults who are at increased risk of falls. Although the U.S. Preventive Services Task Force and American Academy of Family Physicians do not recommend routine multifactorial intervention to prevent falls in all community-dwelling older adults, they state that it may be appropriate in individual cases...
August 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28925663/top-poems-of-2016-consistent-with-the-principles-of-the-choosing-wisely-campaign
#5
Roland Grad, Mark H Ebell
A challenge in the Choosing Wisely campaign is to identify low-value clinical actions supported by high-quality evidence. We applied a method based on crowdsourcing the Daily POEM (patient-oriented evidence that matters) to identify low-value clinical actions from research studies consistent with the principles of Choosing Wisely. In 2016, we analyzed an average of 1,382 questionnaires on 265 unique POEMs delivered to physician members of the Canadian Medical Association. From these questionnaires, we identified the POEMs ranking highest on one questionnaire item directly linked to reducing overdiagnosis or overtreatment...
August 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28925667/health-literacy-tools-in-the-outpatient-setting
#6
Anne Mounsey, Brianna Sexton
No abstract text is available yet for this article.
August 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28925676/tips-for-preventing-falls
#7
(no author information available yet)
No abstract text is available yet for this article.
August 15, 2017: American Family Physician
https://www.readbyqxmd.com/read/28914280/internal-medicine-resident-engagement-with-a-laboratory-utilization-dashboard-mixed-methods-study
#8
Gregory Kurtzman, Jessica Dine, Andrew Epstein, Yevgenly Gitelman, Damien Leri, Miltesh S Patel, Kyra Ryskina
The objective of this study was to measure internal medicine resident engagement with an electronic medical record-based dashboard providing feedback on their use of routine laboratory tests relative to service averages. From January 2016 to June 2016, residents were e-mailed a snapshot of their personalized dashboard, a link to the online dashboard, and text summarizing the resident and service utilization averages. We measured resident engagement using e-mail read-receipts and web-based tracking. We also conducted 3 hour-long focus groups with residents...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28914285/hospital-medicine-point-of-care-ultrasound-credentialing-an-example-protocol
#9
Benji K Mathews, Michael Zwank
Though the use of point-of-care ultrasound (POCUS) has increased over the last decade, formal hospital credentialing for POCUS may still be a challenge for hospitalists. This document details the Hospital Medicine Department Ultrasound Credentialing Policy from Regions Hospital, which is part of the HealthPartners organization in Saint Paul, Minnesota. National organizations from internal medicine and hospital medicine (HM) have not published recommended guidelines for POCUS credentialing. Revised guidelines for POCUS have been published by the American College of Emergency Physicians, though these are not likely intended to guide hospitalists when working with credentialing committees and medical boards...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28914284/the-weekend-effect-in-hospitalized-patients-a-meta-analysis
#10
Lynn A Pauls, Rebecca Johnson-Paben, John McGready, Jamie D Murphy, Peter J Pronovost, Christopher L Wu
BACKGROUND: The presence of a "weekend effect" (increased mortality rate during Saturday and/or Sunday admissions) for hospitalized inpatients is uncertain. PURPOSE: We performed a systematic review to examine the presence of a weekend effect on hospital inpatient mortality. DATA SOURCES: PubMed, EMBASE, SCOPUS, and Cochrane databases (January 1966-April 2013) were utilized for our search. STUDY SELECTION: We examined the mortality rate for hospital inpatients admitted during the weekend compared with those admitted during the workweek...
September 2017: Journal of Hospital Medicine: An Official Publication of the Society of Hospital Medicine
https://www.readbyqxmd.com/read/28914621/ce-original-research-exploring-how-nursing-schools-handle-student-errors-and-near-misses
#11
Joanne Disch, Jane Barnsteiner, Susan Connor, Fabiana Brogren
This study, part 1 of a two-part series, reports survey findings that indicate areas for improvement. ABSTRACT: Background: Little attention has been paid to how nursing students learn about quality and safety, and to the tools and policies that guide nursing schools in helping students respond to errors and near misses. PURPOSE: This study sought to determine whether prelicensure nursing programs have a policy for reporting and following up on student clinical errors and near misses, a tool for such reporting, a tool or process (or both) for identifying trends, strategies for follow-up with students after errors and near misses, and strategies for follow-up with clinical agencies and individual faculty members...
September 13, 2017: American Journal of Nursing
https://www.readbyqxmd.com/read/28899222/effects-of-sotagliflozin-added-to-insulin-in-patients-with-type-1-diabetes
#12
Satish K Garg, Robert R Henry, Phillip Banks, John B Buse, Melanie J Davies, Gregory R Fulcher, Paolo Pozzilli, Diane Gesty-Palmer, Pablo Lapuerta, Rafael Simó, Thomas Danne, Darren K McGuire, Jake A Kushner, Anne Peters, Paul Strumph
Background In most patients with type 1 diabetes, adequate glycemic control is not achieved with insulin therapy alone. We evaluated the safety and efficacy of sotagliflozin, an oral inhibitor of sodium-glucose cotransporters 1 and 2, in combination with insulin treatment in patients with type 1 diabetes. Methods In this phase 3, double-blind trial, which was conducted at 133 centers worldwide, we randomly assigned 1402 patients with type 1 diabetes who were receiving treatment with any insulin therapy (pump or injections) to receive sotagliflozin (400 mg per day) or placebo for 24 weeks...
September 13, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28903154/incidence-and-trends-of-sepsis-in-us-hospitals-using-clinical-vs-claims-data-2009-2014
#13
Chanu Rhee, Raymund Dantes, Lauren Epstein, David J Murphy, Christopher W Seymour, Theodore J Iwashyna, Sameer S Kadri, Derek C Angus, Robert L Danner, Anthony E Fiore, John A Jernigan, Greg S Martin, Edward Septimus, David K Warren, Anita Karcz, Christina Chan, John T Menchaca, Rui Wang, Susan Gruber, Michael Klompas
Importance: Estimates from claims-based analyses suggest that the incidence of sepsis is increasing and mortality rates from sepsis are decreasing. However, estimates from claims data may lack clinical fidelity and can be affected by changing diagnosis and coding practices over time. Objective: To estimate the US national incidence of sepsis and trends using detailed clinical data from the electronic health record (EHR) systems of diverse hospitals. Design, Setting, and Population: Retrospective cohort study of adult patients admitted to 409 academic, community, and federal hospitals from 2009-2014...
September 13, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28899219/adjunctive-treatments-for-type-1-diabetes
#14
David M Nathan
The proliferation of new drug treatments for type 2 diabetes in the United States in the past 15 years, with more than 17 drugs approved in six new classes of antidiabetic drugs, has been promoted by several factors. First, the recognition of the importance of intensive glycemic control to reduce..
September 13, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28902587/hospital-readmission-risk-isolating-hospital-effects-from-patient-effects
#15
Harlan M Krumholz, Kun Wang, Zhenqiu Lin, Kumar Dharmarajan, Leora I Horwitz, Joseph S Ross, Elizabeth E Drye, Susannah M Bernheim, Sharon-Lise T Normand
BACKGROUND: To isolate hospital effects on risk-standardized hospital-readmission rates, we examined readmission outcomes among patients who had multiple admissions for a similar diagnosis at more than one hospital within a given year. METHODS: We divided the Centers for Medicare and Medicaid Services hospital-wide readmission measure cohort from July 2014 through June 2015 into two random samples. All the patients in the cohort were Medicare recipients who were at least 65 years of age...
September 14, 2017: New England Journal of Medicine
https://www.readbyqxmd.com/read/28898377/association-between-laparoscopic-antireflux-surgery-and-recurrence-of-gastroesophageal-reflux
#16
John Maret-Ouda, Karl Wahlin, Hashem B El-Serag, Jesper Lagergren
Importance: Cohort studies, mainly based on questionnaires and interviews, have reported high rates of reflux recurrence after antireflux surgery, which may have contributed to a decline in its use. Reflux recurrence after laparoscopic antireflux surgery has not been assessed in a long-term population-based study of unselected patients. Objectives: To determine the risk of reflux recurrence after laparoscopic antireflux surgery and to identify risk factors for recurrence...
September 12, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28898378/menopausal-hormone-therapy-and-long-term-all-cause-and-cause-specific-mortality-the-women-s-health-initiative-randomized-trials
#17
RANDOMIZED CONTROLLED TRIAL
JoAnn E Manson, Aaron K Aragaki, Jacques E Rossouw, Garnet L Anderson, Ross L Prentice, Andrea Z LaCroix, Rowan T Chlebowski, Barbara V Howard, Cynthia A Thomson, Karen L Margolis, Cora E Lewis, Marcia L Stefanick, Rebecca D Jackson, Karen C Johnson, Lisa W Martin, Sally A Shumaker, Mark A Espeland, Jean Wactawski-Wende
Importance: Health outcomes from the Women's Health Initiative Estrogen Plus Progestin and Estrogen-Alone Trials have been reported, but previous publications have generally not focused on all-cause and cause-specific mortality. Objective: To examine total and cause-specific cumulative mortality, including during the intervention and extended postintervention follow-up, of the 2 Women's Health Initiative hormone therapy trials. Design, Setting, and Participants: Observational follow-up of US multiethnic postmenopausal women aged 50 to 79 years enrolled in 2 randomized clinical trials between 1993 and 1998 and followed up through December 31, 2014...
September 12, 2017: JAMA: the Journal of the American Medical Association
https://www.readbyqxmd.com/read/28895087/benefit-of-adjuvant-radiotherapy-for-local-control-distant-metastasis-and-survival-outcomes-in-patients-with-localized-soft-tissue-sarcoma-comparative-effectiveness-analysis-of-an-observational-cohort-study
#18
Florian Posch, Richard Partl, Carmen Döller, Jakob M Riedl, Maria Smolle, Lukas Leitner, Marko Bergovec, Bernadette Liegl-Atzwanger, Michael Stotz, Angelika Bezan, Armin Gerger, Martin Pichler, Karin S Kapp, Herbert Stöger, Andreas Leithner, Joanna Szkandera
BACKGROUND: This study aimed to quantify the benefit of adjuvant radiotherapy (AXRT) for local control, distant metastasis, and long-term survival outcomes in patients with localized soft tissue sarcoma (STS). METHODS: This single-center retrospective observational study enrolled 433 STS patients who underwent surgery with curative intent. An inverse probability of treatment-weighted (IPTW) analysis was implemented to account rigorously for imbalances in prognostic variables between the adjuvant treatment groups...
September 11, 2017: Annals of Surgical Oncology
https://www.readbyqxmd.com/read/28893115/the-challenges-of-patient-satisfaction-influencing-factors-and-the-patient-provider-relationship-in-the-united-states
#19
Arlinda Baummer-Carr, David P Nicolau
Patient satisfaction is a phenomenon that has become influential in the inpatient setting with the introduction of the Hospital Consumer Assessment of Healthcare Practitioners and Systems (HCAHPS) survey in the United States. Patient satisfaction is a key goal of healthcare organizations and presents some challenges to providing quality patient care. Areas covered: This review will focus on the challenges patient satisfaction presents in the healthcare field, with a key focus on factors that influence patient satisfaction, the common problem of inappropriate antibiotic prescriptions and the importance of the patient-provider relationship...
September 12, 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28889792/overall-survival-with-combined-nivolumab-and-ipilimumab-in-advanced-melanoma
#20
Jedd D Wolchok, Vanna Chiarion-Sileni, Rene Gonzalez, Piotr Rutkowski, Jean-Jacques Grob, C Lance Cowey, Christopher D Lao, John Wagstaff, Dirk Schadendorf, Pier F Ferrucci, Michael Smylie, Reinhard Dummer, Andrew Hill, David Hogg, John Haanen, Matteo S Carlino, Oliver Bechter, Michele Maio, Ivan Marquez-Rodas, Massimo Guidoboni, Grant McArthur, Celeste Lebbé, Paolo A Ascierto, Georgina V Long, Jonathan Cebon, Jeffrey Sosman, Michael A Postow, Margaret K Callahan, Dana Walker, Linda Rollin, Rafia Bhore, F Stephen Hodi, James Larkin
Background Nivolumab combined with ipilimumab resulted in longer progression-free survival and a higher objective response rate than ipilimumab alone in a phase 3 trial involving patients with advanced melanoma. We now report 3-year overall survival outcomes in this trial. Methods We randomly assigned, in a 1:1:1 ratio, patients with previously untreated advanced melanoma to receive nivolumab at a dose of 1 mg per kilogram of body weight plus ipilimumab at a dose of 3 mg per kilogram every 3 weeks for four doses, followed by nivolumab at a dose of 3 mg per kilogram every 2 weeks; nivolumab at a dose of 3 mg per kilogram every 2 weeks plus placebo; or ipilimumab at a dose of 3 mg per kilogram every 3 weeks for four doses plus placebo, until progression, the occurrence of unacceptable toxic effects, or withdrawal of consent...
September 11, 2017: New England Journal of Medicine
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