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JOURNAL ARTICLE
John Nathan Freeman, Callie Giroux, Timothy King, Christina Marbrey, Matthew Maready, Simeen Pasha, Justin Davis
OBJECTIVES: Our objectives were to characterize variations from standardized, evidence-based guidelines in the management of pediatric patients with diabetic ketoacidosis (DKA) based on initial presentation to a tertiary pediatric emergency department (PED) versus a community emergency department (OSH) and compare clinical outcomes. METHODS: We conducted a retrospective study on children 18 years and younger with DKA who presented to an OSH or PED over a 3-year period...
April 2, 2024: Pediatric Emergency Care
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JOURNAL ARTICLE
Rizwan Suliankatchi Abdulkader, Manickam Ponnaiah, Tarun Bhatnagar, Devika S, Amanda G A Rozario, Gayathri K, Malu Mohan, Michaelraj E, Divya Saravanakumar, Aditya Moorthy, Amit Kumar Tyagi, Bhagirathsinh D Parmar, K Devaraja, Gaurav Medikeri, Jutika Ojah, Kajal Srivastava, Karthikeyan K, Nandini Das, Niharika B, Parul Sharma, Pradipta Kumar Parida, Prasanna Kumar Saravanam, Praveen Kulkarni, Priya S, Pushpa Patil S, Rahul Kumar Bagla, Ramesh D, Renuka S Melkundi, Satish S Satpute, Seetharaman Narayanan, Shubhashri Jahagirdar, Simmi Dube, Sunil Kumar Panigrahi, Surendra Babu D, Vaibhav Saini, Rita Singh Saxena, Abhinav Srivastava, Achyut Chandra Baishya, Ajai Garg, Amit Kumar Mishra, Anjan Jyoti Talukdar, Ankita Kankaria, Arathi Karat, Arul Sundaresh Kumar, Ashi Chug, Ashok Vankundre, Balakrishnan Ramaswamy, Bharathi Mb, Bhargav R Jadav, Muthuswamy Dhiwakar, Girija Ghate, Hardik V Shah, Ipsita Saha, Kavya Sivapuram, Krupal J Joshi, Mahendra Singh, Mukesh Chand Bairwa, Divya K, Karthikeyan K, Muthurajesh E, Navneh Samagh, Nethra Dinakaran, Nikhil Gupta, Nitin Gupta, Nitin M Nagarkar, Nitin Solanki, Prasan Kumar Panda, Prithvi Bachalli, Raghunath Shanbag, Rajashri Patil, Rajesh Kumar A, Rakesh Narayan Patil, Ramanikanth Thookkanaickenpalayam Vijayaraghavan, Ramesh Hanumantappa, Rathinavel A, Saleel Kumar Mandal, Sanjay Pandharinath Kishve, Sara Varghese Thomas, Saurav Sarkar, Shalini Thakur, Siddaram Patil, Somu Lakshmanan, Srinivas D Rao, Sumathi V, Tulasi Nayak, Umesh R Dixit, Unnikrishnan B, Varsha Backiavathy, Vijendra Shenoy, Vinay Kumar Hallur, Aparna Bhatnagar, Manoj V Murhekar
In India, the incidence of mucormycosis reached high levels during 2021-2022, coinciding with the COVID-19 pandemic. In response to this, we established a multicentric ambispective cohort of patients hospitalised with mucormycosis across India. In this paper, we report their baseline profile, clinical characteristics and outcomes at discharge. Patients hospitalized for mucormycosis during March-July 2021 were included. Mucormycosis was diagnosed based on mycological confirmation on direct microscopy (KOH/Calcofluor white stain), culture, histopathology, or supportive evidence from endoscopy or imaging...
2024: Mycology
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JOURNAL ARTICLE
Sunil Sharma, Robert Stansbury, Priyanka Srinivasan, Edward Rojas, Stuart F Quan, Kassandra Olgers, Scott Knollinger, Calvin Seol, Malleri Hardison, Jesse Thompson, Nickolas Hansen, Wen Sijin
STUDY OBJECTIVES: Obstructive sleep apnea (OSA) is a highly prevalent, yet under-diagnosed condition. Due to its adverse impact on risk for cardiopulmonary disorders, there is interest in pro-active screening of OSA in hospitalized patients. We studied the long-term outcome of such screened patients who were initiated on positive airway pressure (PAP) therapy. METHODS: Hospitalized patients who screened positive for OSA and were confirmed with post-discharge polysomnography (PSG) were dichotomized by PAP adherence and followed for a period of 12 months to evaluate for the composite endpoint of hospital readmissions and emergency room (ED) visits for cardiopulmonary reasons...
April 1, 2024: Journal of Clinical Sleep Medicine: JCSM: Official Publication of the American Academy of Sleep Medicine
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JOURNAL ARTICLE
Keith Sweitzer, Cody Fowler, James Butterfield, Adam Visca, Danielle Mayorga-Young, Julia Tomtschik, Raquel Arias-Camison, Derek Bell
BACKGROUND: The use of left ventricular assist devices (LVADs) for patients with end-stage cardiac failure awaiting heart transplantation has become increasingly common. However, ventricular assist device-related infections remain a major problem complicating their long-term use. Retrospective review has previously shown a decrease in lifetime return to operating room (RTOR) with no change in 90-day complications when a muscle or omental flap is used for coverage after washout for infection...
April 1, 2024: Annals of Plastic Surgery
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JOURNAL ARTICLE
Christopher Zammitti, Mayra Tisminetzky, Jordy Mehawej, Hawa O Abu, Ruben Miozzo, Joel M Gore, Darleen Lessard, Benita A Bamgbade, Jorge Yarzebski, Jerry H Gurwitz, Robert J Goldberg
BACKGROUND: Multiple chronic conditions (MCCs) are common in patients hospitalized with acute myocardial infarction (AMI). We examined the association of 12 MCCs with the risk of a 30-day hospital readmission and/or dying within one year among those discharged from the hospital after an AMI. We also examined the five most prevalent pairs of chronic conditions in this population and their association with the principal study endpoints. METHODS: The study population consisted of 3,294 adults hospitalized with a confirmed AMI at the three major medical centers in central Massachusetts on an approximate biennial basis between 2005 and 2015...
2024: J Multimorb Comorb
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JOURNAL ARTICLE
Eleanor K Shenton, Amanda G Carter, Laura Gabriel, Valerie Slavin
PROBLEM: Gestational Diabetes Mellitus (GDM) is a complication of pregnancy which may exclude women from midwife-led models of care. BACKGROUND: There is a paucity of research evaluating the safety and feasibility of continuity of midwifery care (CoMC) for women with GDM. AIM: To investigate the impact of CoMC on maternal and neonatal outcomes, for otherwise low-risk women with GDM. METHODS: This exploratory cross-sectional study observed maternal and neonatal outcomes including onset of labour, augmentation, labour analgesia, mode of birth, perineal trauma, gestation at birth, shoulder dystocia, infant birth weight, neonatal feeding at discharge...
March 27, 2024: Women and Birth
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JOURNAL ARTICLE
Elizabeth Miles, Melissa McKnight, Claire C Schmitz, Chelsea R McElroy, Jana L Wardian, Valerie Shostrom, Preethi Polavarapu
BACKGROUND: Insulin, a high-risk medication, is prone to prescribing errors. Patients with diabetes experience higher hospitalization rates and extended hospital stays. Prescription errors, such as missing orders, inappropriate insulin type, missing instructions, and lack of appropriate intensification of insulin regimens are common issues. This project explored the use of system-based interventions and educational tools to minimize errors and improve the quality of insulin discharge regimens...
March 28, 2024: Journal of Diabetes Science and Technology
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Moayad S Almusaylim, Mohammed S Foula, Jawad F Al Amin, Mohammad A Al-Abbad, Mustafa A Alsaleh
Appendicitis, an inflammation of the vermiform appendix, is one of the most common causes of acute abdomen and one of the most frequent indications for emergency abdominal surgery worldwide. Any person older than 65 years old is considered elderly. The elderly population constitutes only 5-10% of total appendicitis cases. The symptoms depend on the location of the appendix. Generally, lower abdominal pain and anorexia are known to be the most common symptoms of appendicitis. Although young adults have a higher prevalence of appendicitis, the elderly have a higher complication rate, 37...
February 2024: Curēus
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JOURNAL ARTICLE
Katherine Li, Saiyini Pirabhahar, Max Thomsett, Kylie Turner, Marina Wainstein, Jeff T Ha, Ivor Katz
BACKGROUND: With rising costs and burden of chronic kidney disease (CKD), timely referral of patients to a kidney specialist is crucial. Currently, Kidney Health Australia (KHA) uses a 'heat map' based on severity and not future risk of kidney failure, whereas the kidney failure risk equation (KFRE) score predicts future risk of progression. AIMS: Evaluate whether a KFRE score assists with timing of CKD referrals. METHODS: Retrospective cohort of 2137 adult patients, referred to tertiary hospital outpatient nephrologist between 2012 and 2020, were analysed...
March 26, 2024: Internal Medicine Journal
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JOURNAL ARTICLE
John Robins, Irem Patel, Ann McNeill, John Moxham, Arran Woodhouse, Gareth Absalom, Buljana Shehu, Geraldine Bruce, Amy Dewar, Alanna Molloy, Stephanie Duckworth Porras, Michael Waring, Andrew Stock, Debbie Robson
BACKGROUND: The National Health Service in England aims to implement tobacco dependency treatment services in all hospitals by 2024. We aimed to assess the uptake of a new service, adapted from the Ottawa Model of Smoking Cessation, and its impact on 6-month quit rates and readmission or death at 1-year follow-up. METHODS: We conducted a pragmatic service evaluation of a tobacco dependency service implemented among 2067 patients who smoked who were admitted to 2 acute hospitals in London, England, over a 12-month period from July 2020...
March 25, 2024: BMC Medicine
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Lakshmi Polisetty, Sneha Teresa Selvin, Jia Wei Tan
Diabetic ketoacidosis (DKA) is a life-threatening medical condition. Alpelisib, a new drug used to treat phosphatidylinositol-4,5-bisphosphate 3-kinase catalytic subunit alpha mutated breast cancer, is reported to cause DKA as a rare adverse effect. We present a case of alpelisib-induced DKA in a patient with metastatic breast cancer without diabetes. An 81-year-old female with a history of hormone receptor-positive, human epidermal growth factor receptor 2-negative metastatic breast cancer presented to the emergency room with clinical features and blood work consistent with DKA...
April 2024: JCEM Case Rep
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JOURNAL ARTICLE
Vaishnavi J Patel, Victoria Delano, Aishwarya Juttu, Huraiya Adhora, Aroob Zaheer, Leticia Vargas, Blaine Jacobs
Introduction Over the past 20 years, the number of pregnancy-related fatalities in the United States has been on the rise. Increases in maternal and fetal mortality have been attributed to low socioeconomic status (SES). This raises the question of whether all geographical locations are proportionally affected by this upward trend in pregnancy-related fatalities. San Antonio is one of the largest cities in the United States and is known for its economic segregation. This study aims to compare the maternal and fetal health outcomes of mothers from diverse socioeconomic backgrounds in San Antonio, Texas...
February 2024: Curēus
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JOURNAL ARTICLE
William R Lorenz, Alexis M Holland, Brittany S Mead, Gregory T Scarola, Vedra A Augenstein, B Todd Heniford
An analysis of ACS-NSQIP open ventral hernia repair (OVHR) data (2017-2019) was performed. Respiratory failure (RF) occurred in 643 patients (1%) and not in 63,213 (99%) (nRF). Respiratory failure patients were older (63.7 vs 57 years, P < .001) and more comorbid: insulin-dependent diabetes (14.7% vs 5.8%, P < .001), COPD (19.4% vs 5.2%, P < .001), BMI (36.0 vs 32.8, P < .001), and current tobacco use (24.9% vs 17.6%, P < .001). Respiratory failure patients had greater ASA scores (ASA 3: 63...
March 24, 2024: American Surgeon
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JOURNAL ARTICLE
Mayura Thilanka Iddagoda, Michelle Trevenen, Claire Meaton, Christopher Etherton-Beer, Leon Flicker
INTRODUCTION: Trauma is the most common cause of morbidity and mortality in older people and it is important to determine the predictors of outcomes after major trauma in older people. METHODS: MEDLINE, Embase, Web of Science and manual search of relevant papers since 1987 to February 2023 was searched. Random effects meta-analyses were performed. The primary outcome of interest was mortality and secondary outcomes were medical complications, length of stay, discharge destination, readmission, and intensive care requirement...
March 25, 2024: Journal of Trauma and Acute Care Surgery
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JOURNAL ARTICLE
Zain A Bhutta, Naveed Akhtar, Sameer A Pathan, Maaret Castren, Tim Harris, Gowrii S Ganesan, Saadat Kamran, Stephen H Thomas, Peter A Cameron, Aftab M Azad, Tuukka Puolakka
OBJECTIVES: Stroke prevalence is progressively increasing in developing countries due to increased vascular risk factors. This study aims to describe the epidemiology, prevalent risk factors, and outcomes of stroke in a multi-ethnic society of Qatar. MATERIALS AND METHODS: We conducted a retrospective analysis of all patients with suspected stroke admitted to stroke services between January 2014 and September 2020. RESULTS: A total of 11,892 patients were admitted during this period with suspected stroke...
March 21, 2024: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
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JOURNAL ARTICLE
Stephania Paredes, Ayoub Harb, Julian Rössler, Maede Zookaei Nikoo, Kurt Ruetzler, Alparslan Turan, Xuan Pu, Daniel I Sessler
INTRODUCTION: The cause of postoperative delirium is unknown, but it is thought to result at least in part from inflammation. Metformin, besides its hypoglycemic properties, demonstrates anti-inflammatory effects systemically and in the brain. We tested the primary hypothesis that chronic metformin use in adults with type 2 diabetes is associated with less delirium during the first 5 days after major noncardiac surgery. Secondary outcomes were a composite of serious complications (myocardial infarction, cardiac arrest, stage 2-3 acute kidney injury [AKI], and mortality) and time to discharge alive...
March 22, 2024: Anesthesia and Analgesia
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JOURNAL ARTICLE
Nuria Roig-Sánchez, Alberto Talaya Peñalver, Noemí Poveda Ruiz, Alfonso Del Pozo, Ana María Hernández Campillo, Alicia Pérez Bernabéu, Belén Martínez-López, Inmaculada González-Cuello, María García-López, Emilio Borrajo Brunete, Philip Wikman-Jorgensen, Jara Llenas-García
OBJECTIVE: Readmission for COVID-19 is associated with high mortality, saturation of health services, and high costs. This study aimed to assess the incidence and risk factors of readmissions in COVID-19 patients in a regional hospital of Spain from February 2020 to March 2021. METHODS: A retrospective cohort study describing the characteristics of adult patients readmitted within thirty days of discharge after being infected with SARS-CoV-2 was carried out. Readmission associated risk factors were analysed using a binary logistic regression model...
March 19, 2024: Revista Española de Salud Pública
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JOURNAL ARTICLE
Khaled Masoud Alrufaidi, Randa Mohammed Nouh, Atheer Abdulaziz Alkhalaf, Nawaf Mufarreh AlGhamdi, Haitham Z Alshehri, Ahmad Mohammad Alotaibi, Ahmed Obaid Almashaykhi, Osama Mohammed AlGhamdi, Hashim Mohammed Makhrashi, Saeed Abdulaziz AlGhamdi, Ahmed Ghormallah AlZahrani, Sahibzada Azhar Mujib, Eman Elsayed Abd-Ellatif
INTRODUCTION: About 2-3 million pilgrims come to Makkah, Saudi Arabia from all countries to perform Hajj. During the Hajj season of 2019 (1440 H), the total number of pilgrims was 2,489,406, of whom 1,855,027 came from foreign countries. This study aims to investigate the prevalence, pattern, and findings of emergency health problems among pilgrims travelling through King Abdul Aziz International Airport Health Care Center (KAIA-HC) at Hajj Terminal in Jeddah during hajj season of 1440-H...
December 2023: Dialogues Health
#39
JOURNAL ARTICLE
Reza Hashempour, SeyedHadi MirHashemi, Fariba Mollajafari, Soheila Damiri, Ali ArabAhmadi, Behzad Raei
BACKGROUND: Diabetic foot ulcer (DFU) is known as a serious complication of diabetes mellitus in patients with diabetes, imposing heavy medical costs on healthcare systems due to its chronic nature. patients with severe diabetic foot ulcer are often disabled to work, and some of them may even die, leading to associated productivity losses. Since no previous study has investigated the economic burden of DFU in Iran, this study is to estimate the economic burden of diabetic foot disease in Iran...
March 21, 2024: BMC Health Services Research
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JOURNAL ARTICLE
Maya T Dassanayake, Elizabeth L Norton, Alison F Ward, Nanette K Wenger
STUDY OBJECTIVE: Examine sex-specific characteristics in patients undergoing coronary artery bypass grafting (CABG) at our institution. DESIGN: Retrospective chart review was performed utilizing our institutional Society of Thoracic Surgeons (STS) database. SETTING: An academic, quaternary care center from 2010 to 2021. PARTICIPANTS: 3163 females and 9573 males underwent isolated CABG. INTERVENTIONS: The institutional STS database was queried for preoperative, intraoperative, and postoperative variables...
November 2023: American heart journal plus: cardiology research and practice
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