Longer length of stay, days between discharge/first readmission, and pulmonary involvement ≥50% increase prevalence of admissions in ICU in unplanned readmissions after COVID‐19 hospitalizations

alexandrossfakianakis shared this article with you from Inoreader Longer length of stay, days between discharge/first readmission, and pulmonary involvement ≥50% increase prevalence of admissions in ICU in unplanned readmissions after COVID‐19 hospitalizations Via Journal of Medical Virology Abstract Hospital readmissions due to COVID-19 are one of the main concerns for the health system due to risks to the patient's life and increased use of health resources. Studies focusing on this issue are important to understand the risk factors and create strategies to avoid readmissions. We evaluated the readmission of patients with confirmed COVID-19 in a private hospital in southern Brazil, between March 2020 and 2021. Also, the characteristics and clinical outcomes of patients admitted to the intensive care unit (ICU) and nonadmitted were compared. Poisson regression models with prevalence ratio (PR) with 95% confidence intervals (95% CIs) were applied to confirm the association between variables and ICU admission. Of the 2084 hospitalized patients with COVID-19, 1806 were discharged alive. Among them, 106 were readmitted for unplanned reasons during one year. Early hospital readmission (≤30 days) occurred in 52.8% of the cases. The main reasons were respiratory, gastroe nterological, kidney, and cardiac disease. The median age was 73.0 years old and women correspond to 52.8%. The presence of at least one comorbidity was detected in 87.7% of patients. Hypertension, diabetes, cardiac, and lung disease were more frequent. The ICU admitted patients (n = 43; 40.5%) mostly had 4–5 comorbidities, pulmonary involvement ≥50%, length of stay (LOS), and days between discharge and first readmission. Longer LOS (PR: 3.46; 95% CI: 1.24–5.67), days between discharge/first readmission (PR: 2.21; 95% CI: 1.15–5.88), and pulmonary involvement (≥50%; PR: 1.59; 95% CI: 1.11–3.54) were independently associated with ICU admission. Longer LOS, longer days between discharge/first readmission, and pulmonary involvement (≥50%) were associated with ICU admission in readmitted patients. Readmissions evaluation is pivotal and may help in ensuring safe care transition and postdischarge follow-up. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Nutritional risk screening in a Danish university hospital is insufficient and may underestimate nutritional risk. A cross‐sectional study

alexandrossfakianakis shared this article with you from Inoreader Nutritional risk screening in a Danish university hospital is insufficient and may underestimate nutritional risk. A cross‐sectional study Via Journal of Human Nutrition and Dietetics Abstract Background Disease-related-malnutrition predicts poor clinical outcomes in elderly patients, and screening is pivotal to identify patients at nutritional risk. This study aimed to investigate nutrition screening rates in electronic patient records, and validate the scores given. Secondary was to investigate whether the proportion of patients at risk differed between patients where screening was documented and those where no screening was documented. Methods This cross-sectional observational study was conducted in a Danish university hospital during November 2020. Patients aged 65 years or more admitted to a medical department were included. The Nutrition Risk Screening (NRS-2002) tool was used to identify patients at nutritional risk, both in routine clinical care, where data were collected retrospectively, and during a validation process in a random patient sample, where data were collected prospectively. Results In total, 817 patients were ad mitted for more than 24 hours. Of these, an NRS-2002 score was documented in 294 (36%), among whom 177 (60%) were at nutritional risk. In 146 patients where no score was documented, 88 (60%) were at risk. Validation was possible in 91 patients where a record-based score and a validated score were documented. The specificity of the record-based score was 100%, while the sensitivity was 75%, indicating that routine screening underestimated nutritional risk (p<0.001, proportion difference 19%(95%CI 10;28%)). Conclusions: Electronic documentation does not solve issues about compliance with nutritional risk screening. In patients where screening was not documented, the occurrence of nutritional risk was similar, indicating that omission of screening is not related to the score. This article is protected by copyright. All rights reserved. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Predictors of posttraumatic stress symptom severity and meaning made in treatment‐seeking veterans

alexandrossfakianakis shared this article with you from Inoreader Predictors of posttraumatic stress symptom severity and meaning made in treatment‐seeking veterans Via Journal of Clinical Psychology Abstract Objective Combat-exposed veterans risk encountering events that disrupt beliefs. To facilitate reduced discrepancy between prior beliefs and current trauma appraisals, veterans may engage in a process of meaning-making. Meaning-making can lead to positive outcomes, such as integrating the traumatic event into one's life narrative or adapting global meaning (meaning made) or elicit distress. Given these potentially different outcomes, this study examined potential correlates of posttraumatic stress symptom (PTSS) severity and meaning made, including relationship attachment dimensions of anxiety and avoidance, and difficulties with emotion regulation, while controlling for combat exposure. Method Veterans receiving mental health services at a Veterans Affairs (VA) Medical Center and a VA community-based outpatient clinic (N = 130) completed measures through a paper-and-pencil survey. Almost all participants (92%) were male, with a mean age of 55.92 years. Results In terms of meaning made, lower levels of attachment anxiety and emotional clarity (an aspect of emotion regulation) predicted higher meaning made. In terms of PTSS severity, higher attachment avoidance, attachment anxiety, and difficulties engaging in goal-directed behavior (an aspect of emotion regulation) significantly predicted higher PTSS severity. Conclusion Aspects of both attachment style and emotion regulation difficulties affect meaning made and PTSS severity. These constructs may be especially relevant for clinicians working with veterans to help PTSS and support meaning made postcombat. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Clinical evaluation of the buccal aspect around immediate implant using dual zone therapeutic concept versus buccal gap fill to bone level: A randomized controlled clinical trial

alexandrossfakianakis shared this article with you from Inoreader Clinical evaluation of the buccal aspect around immediate implant using dual zone therapeutic concept versus buccal gap fill to bone level: A randomized controlled clinical trial Via Clinical Implant Dentistry and Related Research Abstract Objective Soft tissue esthetics for immediate implant is considered challenging when restoring a tooth in an esthetic zone. This study aimed to evaluate the buccal aspect after immediate implant using the dual-zone therapeutic concept compared to grafting the buccal gap to the bone crest. Materials and methods Twenty-four patients were randomly assigned into either immediate implant with the dual-zone therapeutic concept (DZ, test group) or with bone grafting till buccal bone crest with immediate temporization (BCG, control group). Pink esthetic score (PES), buccal bone loss (BBL), mid-facial recession (MFR), soft tissue thickness (STT), keratinized tissue width (KTW), post-operative swelling (POS), and patient satisfaction (PS) were evaluated for 1 year. Results At 12 months the PES in the test group was 11.36 ± 1.69, and 10.80 ± 1.55 in the control group, with no statistically significant difference (p = 0.45). MFR in the DZ and BCG groups was 0.27 ± 0.34 and 0.45 ± 0.44 after 12 months with no statistical significance difference (p = 0.195). The STT assessment showed a statistically significant increase in both groups, however the intergroup comparison was statistically not significant (p = 0.23). The mean KTW in the DZ and BCG groups was 4.55 ± 1.08 and 4.20 ± 0.82 mm, respectively with no statistical significance (p = 0.42). There was no statistical significant difference in patient satisfaction between the two groups except in question number 10 concerning the post-operative swelling which was higher in the DZ group (p = 0.009). Conclusions Both treatment modalities are considered reliable methods to achieve good soft tissue esthetics. However, both treatment modalities were not effective in preventing facial bone resorption despite the use of bone graft. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Thyroarytenoid botulinum toxin injection for refractory laryngeal contact granuloma

alexandrossfakianakis shared this article with you from Inoreader Thyroarytenoid botulinum toxin injection for refractory laryngeal contact granuloma Via ScienceDirect Publication: American Journal of Otolaryngology Publication date: Available online 4 May 2022 Source: American Journal of Otolaryngology Author(s): Yufei Pan, Jinrang Li, Jinhong Zhang, Xiaoyu Wang, Yuanyuan Jia View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Medicine, Religion, and the Humanitarian Ethos:

alexandrossfakianakis shared this article with you from Inoreader Medicine, Religion, and the Humanitarian Ethos: Walter B. Cannon, Unitarianism, and the Care of Spanish Republican Refugees in France Via Journal of the History of Medicine and Allied Sciences - current issue Abstract Biographies of Walter B. Cannon (1871-1945) usually present two sides of his life: one, where he was an outstanding man of science in the United States during the so-called "Golden Age of Medicine," and the other, where he was a leading humanitarian activist engaged in myriad causes, notably in the defense of Spanish democracy during the Civil War (1936-1939). However, these biographies fail to take into account that the apparent link between these two sides of his life was his religious conviction.This study summarizes the aims and accomplishments of the American Medical Bureau to Aid the Spanish Democracy (AMBASD) of which Cannon was chair between 1937 and 1939. Then, it examines Cannon's inspirational role on the international relief work with Spanish Republican refugees in France, through the case of the Varsovie Hospital of Toulouse that between 1945 and 1949 was jointly managed by the Unitarian Service Committee (USC) and the Joint An ti-Fascist Refugee Committee (JAFRC), and renamed Varsovie Hospital/Walter B. Cannon Memorial in recognition of the Spanish Republicans' debt for his extraordinary contribution during the Spanish Civil War and beyond. Finally, the article investigates the Unitarian roots of Cannon's humanitarian ethos by exploring the historical relations of this religious movement with science and with many major actors at Harvard University as well as the links of Cannon's relatives to Unitarianism.The analysis reveals Unitarianism's influence on Cannon's views about science, democracy, and liberty, as well as on his remarkable involvement in the medical solidarity movement with the Second Spanish Republic and other similar commitments. In sum, it shows how important is to branch out in our studies of medical and scientific practice to include practitioners' broader social and religious communities in order to understand their motivations, achievements, and behavior. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.

Association of comorbidity score with perioperative outcomes following transoral robotic surgery: National analysis

alexandrossfakianakis shared this article with you from Inoreader Association of comorbidity score with perioperative outcomes following transoral robotic surgery: National analysis Via Head & Neck Abstract Background The association of comorbidities with perioperative outcomes after transoral robotic surgery (TORS) is not well-defined in the literature. Methods Using the National Cancer Database, 4004 patients with T1-T2 oropharyngeal cancer between 2010 and 2017 were stratified based on their Charlson–Deyo Comorbidity Class (CDCC). Thirty-day unplanned readmissions, 30-day mortality, and 90-day mortality were compared using chi-square test and logistic regression. Hospital length of stay (LOS) was compared using the Kruskal–Wallis test. Results LOS was greater for patients with CDCC 2 or 3 compared to CDCC 0 or 1 (p < 0.001). Increasing age and CDCC ≥3 were associated with 30-day mortality (CDCC ≥3: odds ratio [OR] 5.55, 95% confidence interval [CI] 1.59–19.45). CDCC ≥3 (OR 2.61, 95%CI 1.09–6.27) was significantly associated with 30-day readmissions. Conclusion This national analysis demonstrates greater rates of unplanned 30-day readmissions, longer hospitalizations, and increased 30- and 90-day mortality after TORS in patients with CDCC ≥3. View on the web Inoreader. Take back control of your news feed. Follow us on Twitter and Facebook.