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The overall incidence of infections due to the five studied organisms was 116.9 cases per 100,000 patient days with E. coli urinary tract infections (UTI)s contributing the largest proportion (51 cases per 100 000 patient days). The impact of a UTI on hospital stay was moderate across the five studied pathogens. Resistance significantly increased hospital stay for patients with third-generation cephalosporin-resistant K. HS148 pneumoniae bloodstream infection (BSI) (extra 4.6 days) and methicillin-resistant S. aureus (MRSA) BSI (extra 2.9 days). Consequently, healthcare costs of these infections were higher, compared to corresponding drug-sensitive strains.

The health burden remains highest for BSIs, however the UTIs and respiratory tract infections (RTI) contributed most to the healthcare system expenditure.

The health burden remains highest for BSIs, however the UTIs and respiratory tract infections (RTI) contributed most to the healthcare system expenditure.

The Affordable Care Act expanded access to Medicaid coverage in 2014 for individuals living in participating states. Whether expanded coverage was associated with increases in the use of outpatient surgical care, particularly among underserved populations, remains unknown.

To evaluate the association between state participation in the Affordable Care Act Medicaid expansion reform and the use of outpatient surgical care.

This case-control study used a quasi-experimental difference-in-differences design to compare the use of outpatient surgical care at the facility and state levels by patient demographic characteristics and payer categories (Medicaid, private insurance, and no insurance). Data from 2013 (before Medicaid expansion reform) and 2015 (after Medicaid expansion reform) were obtained from the State Ambulatory Surgery and Services Database of the Healthcare Cost and Utilization Project. The absolute and mean numbers of procedures performed at outpatient surgical centers in 2 states (Michigan and es, and open inguinal hernia repairs in expansion states than in nonexpansion states.

Study results suggest that Medicaid expansion was associated with increases in the use of outpatient surgical care in states that participated in Medicaid expansion. Most of this increase represented patients who were newly treated rather than patients who converted from no insurance to Medicaid coverage.

Study results suggest that Medicaid expansion was associated with increases in the use of outpatient surgical care in states that participated in Medicaid expansion. Most of this increase represented patients who were newly treated rather than patients who converted from no insurance to Medicaid coverage.

Functional outcomes have value for older adults who undergo surgical procedures. Preventing postoperative functional decline in this patient population necessitates the identification of the factors associated with this outcome and minimizing their implications.

To assess the prevalence of functional decline 30 days after a surgical procedure among older adults 80 years or older, examine the risk factors of this decline, and identify ways to minimize this decline by addressing its mutable factors.

This retrospective cohort study used patient data from the Geriatric Surgery Pilot Project, a multi-institutional data registry of the American College of Surgeons National Surgical Quality Improvement Program. Inclusion criteria were patients 80 years or older who underwent a surgical procedure that required an inpatient stay at 1 of 23 hospitals enrolled in the Geriatric Surgery Pilot Project from January 1, 2015, to December 31, 2018, and had preoperative and postoperative functional health status data. Datopulation.

In this study, 1 in 5 older adults experienced a functional decline that persisted 30 days after a surgical procedure, an outcome that appeared to be associated with several geriatric-specific risk factors. Future trials are needed to evaluate whether the prevention or mitigation of these factors can decrease the rates of postoperative functional decline in this patient population.

Congenital heart disease in adults is still a relatively new concept for many cardiologists, and the complexity as well as diversity of cardiac phenotypes encountered necessitate that systematic, practical information be available for the nonspecialist. The analysis of the 12-lead electrocardiogram is an invaluable cornerstone in the clinical appraisal of these patients.

Consideration of the main anatomic and pathophysiological aspects of the various congenital heart conditions can shed light on their distinctive electrocardiogram patterns, which are an electrical reflection of intrinsic cardiac anatomy abnormalities, surgical scarring, and progressive cardiac remodeling attributable to hemodynamic perturbations. While congenital heart disease may be diagnosed or suspected on electrocardiogram observation in adults who are previously undiagnosed, specific markers have also been identified to optimize risk stratification in certain defects.

This review outlines that main electrocardiogram patterns in adult patients with congenital heart disease can be appreciated by the understanding of the underlying pathophysiology. Periodic surveillance is of particular importance in this population to unmask early electric signs of disease evolution.

This review outlines that main electrocardiogram patterns in adult patients with congenital heart disease can be appreciated by the understanding of the underlying pathophysiology. Periodic surveillance is of particular importance in this population to unmask early electric signs of disease evolution.

Treating older adults with psoriasis can be challenging owing to comorbidities, concomitant medication use, and consequent safety risks. Although many studies focus on the effectiveness and safety of systemic antipsoriatic therapies in the general population, their effectiveness in older adults with psoriasis has not been systematically assessed.

To evaluate the effectiveness and safety of systemic antipsoriatic therapies in patients 65 years or older.

A systematic literature search was conducted in Embase, MEDLINE, and the Cochrane Central Register of Controlled Trials (CENTRAL) on November 11, 2019. No date limit was used. Randomized clinical trials, cohort studies, large case series, and meta-analyses assessing efficacy (or effectiveness) and/or safety of systemic antipsoriatic therapies in patients 65 years or older were included.

The initial search yielded 11 096 results, of which 31 unique articles with 39 561 patients were included in analysis. Overall, limited data were available per systemic agent, and overall quality of the included studies on conventional systemic therapies was low.