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https://www.readbyqxmd.com/read/29332175/breast-cancer-survivor-s-perspectives-on-the-role-different-providers-play-in-follow-up-care
#1
J L Tucholka, N Jacobson, N M Steffens, J R Schumacher, A J Tevaarwerk, B Anderson, L G Wilke, C C Greenberg, Heather B Neuman
IMPORTANCE: Significant variation in the number and types of oncologists that provide breast cancer follow-up exists. However, there is limited understanding regarding breast cancer survivors' preferences for who provides their follow-up. Our objective was to explore breast cancer survivors' perspectives on the goals of breast cancer follow-up, the preferred role for primary care providers, and the perceived roles of different types of oncologists during follow-up. METHODS: A convenience sample of stage 0-III breast cancer survivors was identified and in-depth one-on-one interviews conducted...
January 13, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29331796/determination-of-meropenem-in-endotracheal-tubes-by-in-tube-solid-phase-microextraction-coupled-to-capillary-liquid-chromatography-with-diode-array-detection
#2
L Hakobyan, J Pla Tolos, Y Moliner-Martinez, C Molins-Legua, Jesús Ruiz Ramos, M Gordon, Paula Ramirez-Galleymore, P Campins-Falco
Meropenem is a widely used antimicrobial for the treatment of infections associated with the use of invasive medical devices in intensive care unit patients. These treatments are not always effective, in fact, in-vitro studies have demonstrated the difficulty of antimicrobials to penetrate into the biofilm, however in-vivo studies of the effect of these compounds is a trend, mostly because of the complexity of pulmonary samples extracted from ETTs. Therefore, the objective of this study was to evaluate in-tube solid phase microextraction (in-tube SPME) coupled to capillary liquid chromatography (CapLC) with DAD to determine meropenem in ETTs in order to estimate the penetration capability into the biofilm...
January 8, 2018: Journal of Pharmaceutical and Biomedical Analysis
https://www.readbyqxmd.com/read/29331668/earlier-and-enhanced-rehabilitation-of-mechanically-ventilated-patients-in-critical-care-a-feasibility-randomised-controlled-trial
#3
David McWilliams, Charlotte Jones, Gemma Atkins, James Hodson, Tony Whitehouse, Tonny Veenith, Emma Reeves, Lauren Cooper, Catherine Snelson
BACKGROUND: Systematic reviews of early rehabilitation within intensive care units have highlighted the need for robust multi-centre randomised controlled trials with longer term follow up. This trial aims to explore the feasibility of earlier and enhanced rehabilitation for patients mechanically ventilated for ≥5days and to assess the impact on possible long term outcome measures for use in a definitive trial. METHODS: Patients admitted to a large UK based intensive care unit and invasively ventilated for ≥5days were randomised to the rehabilitation intervention or standard care on a 1:1 basis, stratified by age and SOFA score...
January 4, 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29331011/transfusion-related-acute-lung-injury-in-a-paediatric-intensive-care-unit-of-pakistan
#4
Muhammad Tariq Jamil, Zehra Dhanani, Qalab Abbas, Humaira Jurair, Farheen Karim Mahar, Anwarul Haque
Background: Transfusion-Related Acute Lung Injury (TRALI) is a major cause of transfusionrelated morbidity and mortality in the intensive care unit setting. There is a paucity of such data from Pakistan. The purpose of this study is to assess the incidence and outcome of TRALI in critically ill children admitted in a pediatric intensive care unit (PICU) of Pakistan. Methods: This is a retrospective cohort study of all critically ill or injured children who developed TRALI or "possible" TRALI after blood transfusion based on Canadian Conference Consensus criteria in a closed multidisciplinary-cardiothoracic PICU from January 2012 to June 2016...
October 2017: Journal of Ayub Medical College, Abbottabad: JAMC
https://www.readbyqxmd.com/read/29330241/primary-care-physician-involvement-in-shared-decision-making-for-critically-ill-patients-and-family-satisfaction-with-care
#5
Kevin B Huang, Urs Weber, Jennifer Johnson, Nathanial Anderson, Andrea K Knies, Belinda Nhundu, Cynthia Bautista, Kelly Poskus, Kevin N Sheth, David Y Hwang
PURPOSE: An intensive care unit (ICU) patient's primary care physician (PCP) may be able to assist family with certain ICU shared medical decisions. We explored whether families of patients in nonopen ICUs who nevertheless report involvement of a patient's PCP in medical decision making are more satisfied with ICU shared decision making than families who do not. METHODS: Between March 2013 and December 2015, we administered the Family Satisfaction in the ICU 24 survey to family members of adult neuroscience ICU patients...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29330232/interventions-must-be-realistic-to-be-useful-and-completed-in-family-medicine
#6
EDITORIAL
Marjorie A Bowman, Dean A Seehusen, Anne Victoria Neale
Being realistic while helping our patients is this issue's theme. Given the volume of tasks required in family medicine, recommendations for improvements in direct care or care measurement cannot just be evidence-based but must also be realistic. On the list of realistic: ordering antipsychotics for symptoms of dementia in the elderly, despite recommendations to not do so; ordering antidepressants without fear that the patient could develop hypertension; mental health care providers in primary care offices; forced choice for opioid management; plus agenda setting for visit efficiency...
January 2018: Journal of the American Board of Family Medicine: JABFM
https://www.readbyqxmd.com/read/29329118/ce-managing-sepsis-and-septic-shock-current-guidelines-and-definitions
#7
Mary Beth Flynn Makic, Elizabeth Bridges
Recent updates emphasize early recognition and prompt intervention. ABSTRACT: Sepsis is a leading cause of critical illness and hospital mortality. Early recognition and intervention are essential for the survival of patients with this syndrome. In 2002, the Society of Critical Care Medicine (SCCM) and the European Society of Intensive Care Medicine (ESICM) launched the Surviving Sepsis Campaign (SSC) to reduce overall patient morbidity and mortality from sepsis and septic shock by driving practice initiatives based on current best evidence...
January 11, 2018: American Journal of Nursing
https://www.readbyqxmd.com/read/29328872/the-sustainability-of-evidence-based-interventions-and-practices-in-public-health-and-health-care
#8
Rachel C Shelton, Brittany Rhoades Cooper, Shannon Wiltsey Stirman
There is strong interest in implementation science to address the gap between research and practice in public health. Research on the sustainability of evidence-based interventions has been growing rapidly. Sustainability has been defined as the continued use of program components at sufficient intensity for the sustained achievement of desirable program goals and population outcomes. This understudied area has been identified as one of the most significant translational research problems. Adding to this challenge is uncertainty regarding the extent to which intervention adaptation and evolution are necessary to address the needs of populations that differ from those in which interventions were originally tested or implemented...
January 12, 2018: Annual Review of Public Health
https://www.readbyqxmd.com/read/29328014/-innovation-in-transport-of-critical-care-patients
#9
Q Muijrers, O Thomas
The differentiation of specialist care means that not every hospital can meet specific care requirements. Because of this, frequent transport of critical care patients is necessary. In most circumstances, regular ambulance transport is used, either with or without an accompanying physician. In some cases, a mobile intensive care unit (MICU) can be deployed. However, the MICU is not 24/7 operational in our area and significant waiting times can occur. Additionally, space and resources in a regular ambulance are limited...
2018: Nederlands Tijdschrift Voor Geneeskunde
https://www.readbyqxmd.com/read/29327197/-new-kidney-function-tests-renal-functional-reserve-and-furosemide-stress-test
#10
REVIEW
D Kindgen-Milles, T Slowinski, T Dimski
Acute kidney injury (AKI) occurs in 30-50% of all intensive care patients. Renal replacement therapy (RRT) has to be initiated in 10-15%. The early in-hospital mortality is about 50%. Up to 20% of all survivors develop chronic kidney disease after intensive care discharge and progress to end-stage kidney disease within the next 10 years. For timely initiation of prophylactic or therapeutic interventions, it is crucial to exactly determine the actual kidney function, i. e., glomerular filtration rate (GFR), and to gain insight into the further development of kidney function...
January 11, 2018: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/29326015/ecchymosis-and-or-haematoma-formation-after-prophylactic-administration-of-subcutaneous-enoxaparin-in-the-abdomen-or-arm-of-the-critically-ill-patient
#11
R Jareño-Collado, M M Sánchez-Sánchez, M P Fraile-Gamo, N García-Crespo, S Barba-Aragón, H Bermejo-García, R Sánchez-Izquierdo, E I Sánchez-Muñoz, A López-López, S Arias-Rivera
INTRODUCTION: Ecchymosis and/or haematoma are the most common adverse events after subcutaneous administration of low molecular weight heparin. There is no strong recommendation as to the puncture site. OBJECTIVE: To evaluate the adverse events, ecchymosis and/or haematoma after the administration of prophylactic subcutaneous enoxaparin in the abdomen vs the arm in the critically ill patient. METHODOLOGY: A randomised, two-arm clinical trial (injection in the abdomen vs the arm), performed between July 2014 and January 2017, in an 18-bed, polyvalent intensive care unit...
January 8, 2018: Enfermería Intensiva
https://www.readbyqxmd.com/read/29325842/use-of-dexmedetomidine-in-cardiothoracic-and-vascular-anesthesia
#12
REVIEW
Lucía Gallego-Ligorit, Marc Vives, Jorge Vallés-Torres, T Alberto Sanjuán-Villarreal, Azucena Pajares, Mario Iglesias
Dexmedetomidine is a highly selective α2-adrenergic agonist with analgesic and sedative properties. In the United States, the Food and Drug Administration approved the use of the drug for short-lasting sedation (24 h) in intensive care units (ICUs) in patients undergoing mechanical ventilation and endotracheal intubation. In October 2008, the Food and Drug Administration extended use of the drug for the sedation of nonintubated patients before and during surgical and nonsurgical procedures. In the European Union, the European Medicine Agency approved the use of dexmedetomidine in September 2011 with a single recognized indication: ICU adult patients requiring mild sedation and awakening in response to verbal stimulus...
December 2, 2017: Journal of Cardiothoracic and Vascular Anesthesia
https://www.readbyqxmd.com/read/29324960/impact-of-critical-illness-news-on-the-family-hermeneutic-phenomenological-study
#13
Anabela Pereira Mendes
OBJECTIVE: Understand the impact of critical-illness news on the experience of family members at an Intensive Care Unit. METHOD: Phenomenological approach according to Van Manen's method. Open interviews were held with 21 family members. From analysis and interpretation of the data, three essential themes were identified: the unexpected; the pronouncement of death; and the impact on self-caring within the family. The study complied with the ethical principles inherent to research involving humans...
January 2018: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/29324628/ulinastatin-protects-against-lps-induced-acute-lung-injury-by-attenuating-tlr4-nf-%C3%AE%C2%BAb-pathway-activation-and-reducing-inflammatory-mediators
#14
Chao Cao, Chengfen Yin, Songtao Shou, Jun Wang, Lechang Yu, Xuening Li, Yanfen Chai
Acute lung injury (ALI) and its severe form, acute respiratory distress syndrome (ARDS), remain the leading causes of morbidity and mortality in intensive care units. Ulinastatin (UTI), a serine protease inhibitor, possesses anti-inflammatory properties and has been suggested to modulate lipopolysaccharide (LPS)-induced sepsis; thus, it is now widely used in the treatment of pancreatitis, sepsis, and septic shock. Toll-like receptor 4 (TLR4), an essential LPS signaling receptor, plays a critical role in the activation of innate immunity...
January 10, 2018: Shock
https://www.readbyqxmd.com/read/29323761/chronic-critical-illness-application-of-what-we-know
#15
REVIEW
Martin D Rosenthal, Amir Y Kamel, Cameron M Rosenthal, Scott Brakenridge, Chasen A Croft, Frederick A Moore
Over the last decade, chronic critical illness (CCI) has emerged as an epidemic in intensive care unit (ICU) survivors worldwide. Advances in ICU technology and implementation of evidence-based care bundles have significantly decreased early deaths and have allowed patients to survive previously lethal multiple organ failure (MOF). Many MOF survivors, however, experience a persistent dysregulated immune response that is causing an increasingly predominant clinical phenotype called the persistent inflammation, immunosuppression, and catabolism syndrome (PICS)...
January 11, 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29323759/barriers-and-solutions-to-delivery-of-intensive-care-unit-nutrition-therapy
#16
REVIEW
Michelle Kozeniecki, Heather Pitts, Jayshil J Patel
Despite recommendations for early enteral nutrition (EN) in critically ill patients, numerous factors contribute to incomplete delivery of EN, including insufficient nutrition risk screening in critically ill patients, underutilization of enteral feeding protocols, fixed rate-based enteral infusion targets with frequent EN interruption, and suboptimal provider practices regarding nutrition support therapy. The purpose of this narrative review is to identify common barriers to optimizing and delivering nutrition in critically ill patients, and suggest strategies and solutions to overcome barriers...
January 11, 2018: Nutrition in Clinical Practice
https://www.readbyqxmd.com/read/29322820/reevaluation-of-the-critically-ill-patients-with-nonconvulsive-status-epilepticus-by-using-salzburg-consensus-criteria
#17
Ozlem Gungor Tuncer, Ebru Altindag, Sevda Ozel Yildiz, Mecbure Nalbantoglu, Mehmet Eren Acik, Sedef Tavukcu Ozkan, Betul Baykan
OBJECTIVE: We aimed to assess the usefulness of the Salzburg Consensus Criteria (SCC) for determining the prognosis of critically ill patients with nonconvulsive status epilepticus (NCSE). METHODS: We retrospectively reviewed consecutive patients with unconsciousness followed up in the intensive care unit (ICU). Three clinical neurophysiologists, one of them blinded to clinical and laboratory data, reevaluated all EEG data independently and determined NCSE according to SCC...
January 1, 2018: Clinical EEG and Neuroscience: Official Journal of the EEG and Clinical Neuroscience Society (ENCS)
https://www.readbyqxmd.com/read/29322491/influence-of-prehospital-function-and-strength-on-outcomes-of-critically-ill-older-adults
#18
D Clark Files, Rebecca Neiberg, Julia Rushing, Peter E Morris, Michael P Young, Hilsa Ayonayon, Tamara Harris, Anne Newman, Susan Rubin, Eric Shiroma, Denise Houston, Michael E Miller, Stephen B Kritchevsky
OBJECTIVES: To understand the influence of prehospital physical function and strength on clinical outcomes of critically ill older adults. DESIGN: Secondary analysis of prospective cohort study. SETTING: Health, Aging and Body Composition (Health ABC) Study. PARTICIPANTS: Of 3,075 older adult Health ABC participants, we identified 575 (60% white, 61% male, mean age 79) with prehospital function or grip strength measurements within 2 years of an intensive care unit stay...
January 11, 2018: Journal of the American Geriatrics Society
https://www.readbyqxmd.com/read/29321041/effects-of-stress-ulcer-prophylaxis-in-adult-icu-patients-receiving-renal-replacement-therapy-sup-icu-renal-siren-study-protocol-for-a-pre-planned-observational-study
#19
Joerg C Schefold, Anders Perner, Theis Lange, Jørn Wetterslev, Matt P Wise, Mark Borthwick, Stepani Bendel, Frederik Keus, Anne Berit Guttormsen, Søren Marker, Mette Krag, Morten Hylander Møller
BACKGROUND: Proton pump inhibitors are often used in critically ill patients to prevent gastrointestinal bleeding despite limited evidence for benefit. Patients with acute kidney injury requiring renal replacement therapy (RRT) are at high risk of gastrointestinal bleeding as (pre-)uremia induces coagulopathy through effects on platelets and coagulation cascades. No high-quality randomized clinical trials have previously assessed the benefits and harms of prophylactic proton pump inhibitor use in this high-risk population of adult critically ill patients...
January 10, 2018: Trials
https://www.readbyqxmd.com/read/29320720/simultaneous-emergence-and-rapid-spread-of-three-oxa-23-producing-acinetobacter-baumannii-st208-strains-in-intensive-care-units-confirmed-by-whole-genome-sequencing
#20
Qiong Chen, Jia-Wei Zhou, Jian-Zhong Fan, Sheng-Hai Wu, Li-Hui Xu, Yan Jiang, Zhi Ruan, Yun-Song Yu, Dao-Jun Yu, Xian-Jun Wang
Carbapenem-resistant Acinetobacter baumannii (CRAB) is a common nosocomial bacterial pathogen with limited treatment options. CRAB outbreaks are disastrous for critically ill patients. This study investigated carbapenemase-produced A. baumannii outbreaks in a tertiary hospital. Although multiple outbreaks were suggested by pulse-field gel electrophoresis, the genetic lineages and evolution between these isolates were not clear. To investigate the genomic epidemiology of these outbreaks and to reveal possible transmission routes, whole genome sequences (WGS) were compared and analyzed...
January 7, 2018: Infection, Genetics and Evolution
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