Outcomes among patients with non-ST-elevation myocardial infarction on chronic anticoagulation: Insights from the National Inpatient Sample.

Background: Chronic systemic anticoagulation use is prevalent for various thromboembolic conditions. Anticoagulation (usually through heparin products) is also recommended for the initial management of non-ST-elevation myocardial infarction (NSTEMI).

Aims: To evaluate the in-hospital outcomes of patients with NSTEMI who have been on chronic anticoagulation.

Disparities in Acute Coronary Syndrome Outcomes in Individuals With Intellectual Disabilities: A Propensity-Matched Analysis of National Inpatient Sample.

Background: Individuals with intellectual disabilities (IDs) are at similar risk of acute coronary syndrome (ACS) as compared to general population. However, there is a paucity of real-world data evaluating outcomes of ACS in this population. We sought to study ACS outcomes in individuals with IDs using a large national database.

Iatrogenic Cushing Syndrome in a 47-Year-Old HIV-Positive Woman on Ritonavir and Inhaled Budesonide.

Iatrogenic Cushing syndrome (CS) is a well-known complication of treating patients with systemic steroids. More rarely, it has been described in HIV-positive patients on ritonavir (RTV) while using the inhaled corticosteroid fluticasone, which is metabolized through the cytochrome P450 3A4 (CYP3A4) enzyme system. In the presence of RTV, a known CYP3A4 enzyme inhibitor, the interaction can result in impaired metabolism and systemic accumulation of inhaled fluticasone resulting in iatrogenic CS.

: A case report and concise review.

species are bacteria found commonly in environmental sources, such as water and soil. Despite this, they are historically uncommon pathogens, tending to affect primarily immunocompromised hosts. Based on a review of the current cases listed in the U.

Engaging patients with heart failure into the design of health system interventions: Impact on research methods.

The purpose of this study was to engage patients with heart failure (HF) to assess if changes are needed in a research study design, methods and outcomes when transferring interventions used in urban/community hospitals to rural hospital settings. A qualitative structured interview was conducted with eight patients with a diagnosis of HF admitted to two rural hospitals. Patients validated the study design, measures and outcomes, but identified one area that should be added to the study protocol, symptom experience.

Recommended immunizations for older adults: a primer for pharmacists.

Objective: To assess the effectiveness and safety of currently recommended vaccines in older adults.

Data Sources: PubMed was used to search for relevant articles. Key words searched included: immunosenescence, influenza vaccine efficacy, influenza vaccine safety, Tdap safety and efficacy elderly, Td safety and efficacy elderly, pneumococcal vaccine safety and efficacy elderly, pneumococcal vaccine efficacy, Recombivax safety and efficacy elderly, Zostavax safety and efficacy, influenza vaccine timing, frailty and immunosenescence.

A case of subluxation of the radial head: nursemaids' elbow.

Nursemaid's elbow (subluxation of the radial head) is a common pediatric upper extremity injury encountered in the emergency and urgent care settings. Subluxation of the radial head accounts for more than 20% of upper extremity injuries in the pediatric population. A clinical case of a three-year old girl who presented to the emergency department with a nursemaids elbow requiring reduction is presented in this article.

Extending automation into the OR.

Explore the merits of this concept for improved medication management.

Licensed practical nurse to registered nurse transition: developing a tailored orientation.

This article depicts the journey that the clinical educators of a 296-bed community hospital pursued to develop a specific orientation pathway for the licensed practical nurse to registered nurse transition. When the orientation templates were originally developed, the new hires transitioning from LPN to RN were placed in the experienced nurse pathway without considering that they would have specific developmental needs. This journey reflects the educational challenges and subsequent revisions that were made for this specific population.

Progress meetings: facilitating role transition of the new graduate.

Although the very best orientation will not fully eliminate new graduates' sense of anxiety, a successful orientation will guide the novice registered nurse to use these feelings constructively by promoting a sense of confidence, competence, and satisfaction. This article provides details and examples of how progress meetings can be a beneficial addition to an orientation template. Progress meetings offer an avenue to facilitate social support and clinical growth supporting the transition from new graduate nurse to independent staff nurse.

Management of adult patients receiving intraventricular chemotherapy for the treatment of leptomeningeal metastasis.

Cancer in the central nervous system can arise from a primary brain tumor and metastasize to the brain or to the leptomeninges, leading to leptomeningeal metastasis (LM). LM also is called leptomeningeal carcinomatosis and carcinomatous meningitis. When LM occurs, signs and symptoms include headache, nausea, vomiting, lumbar back pain, and stiff or painful neck; LM also may lead to mental disturbances and seizures.

The standing operational implementation team--playing a vital role in successful project completion, implementation of operational initiatives, and process improvement.

The most detailed and well-documented project plan or process improvement initiative will certainly fall short of expectations if the appropriate team is not assembled to execute it. A standing operational implementation team, representing all major stakeholders in the organization, takes the guesswork out of who to engage and when. Applying this concept, as well as some basic project management concepts, can be used to help guide facilitators who are not project management professionals toward successful project completion or process improvement initiatives.

Catamenial hemoptysis.

Catamenial hemoptysis is a rare result of thoracic endometriosis. The long-term treatment of this condition remains controversial. An operation to remove the offending parenchymal endometrial tissue by pulmonary sparing, such as wedge resection, segmentectomy affords satisfactory treatment without the disadvantage of long-term hormone therapy and with the consequent suppression of normal menses and alteration of secondary sexual characteristics in a young woman.