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https://www.readbyqxmd.com/read/27932136/prognostic-value-of-high-sensitivity-troponin-t-to-identify-patients-at-risk-of-left-ventricular-graft-dysfunction-after-heart-transplantation
#1
A B Méndez, J Ordonez-Llanos, S Mirabet, J Galan, M L Maestre, V Brossa, M T Rivilla, L López, T Koller, A Sionis, E Roig
Primary graft dysfunction after heart transplantation (HTx) has a very high mortality rate, especially if the left ventricle (PGD-LV) is involved. Early diagnosis is important to select the appropriate therapy to improve prognosis. The value of high-sensitivity troponin T (HS-TNT) measurement obtained at patient arrival at the intensive care unit was analyzed in 71 HTx patients. Mild or moderate PGD-LV was defined by hemodynamic compromise with one of the following criteria: left ventricular ejection fraction <40%, hemodynamic compromise with right atrial pressure >15 mm Hg, pulmonary capillary wedge pressure >20 mm Hg, cardiac index <2...
November 2016: Transplantation Proceedings
https://www.readbyqxmd.com/read/27931294/long-term-outcome-after-pediatric-intensive-care-unit-asthma-admissions
#2
Ibrahim Abu-Kishk, Sharon Polakow-Farkash, Arnon Elizur
BACKGROUND: Patients with asthma admitted to the pediatric intensive care unit (PICU) are often found to have had previous severe asthma exacerbations. OBJECTIVE: To prospectively evaluate the outcome of children after PICU admission. METHODS: Patients, ages 218 years, admitted to the PICU at Assaf Harofeh Medical Center over a 10-year period were assessed at a mean of 10 years after their admission and compared with matched patients admitted to the pediatric ward...
November 2016: Allergy and Asthma Proceedings:
https://www.readbyqxmd.com/read/27931259/abdominal-septic-shock-endotoxin-adsorption-treatment-asset-endotoxin-removal-in-abdominal-and-urogenital-septic-shock-with-the-alteco%C3%A2-lps-adsorber-study-protocol-for-a-double-blinded-randomized-placebo-controlled-trial
#3
Miklos Lipcsey, Jyrki Tenhunen, Jan Sjölin, Robert Frithiof, Stepani Bendel, Hans Flaatten, Rafael Kawati, Anne Kuitunen, Tor Inge Tønnessen, Sten Rubertsson
BACKGROUND: Severe sepsis and septic shock are common in intensive care and carry high mortality rates. In patients with Gram-negative infections, early and extensive removal of endotoxin may limit the inflammatory response that characterizes septic shock. The Alteco® LPS Adsorber (hereafter referred to cited as the lipopolysaccharide (LPS) Adsorber) can be used for endotoxin removal and attenuate the deleterious inflammatory and clinical responses seen in septic shock. METHODS/DESIGN: The Abdominal Septic Shock - Endotoxin Adsorption Treatment (ASSET) trial is a pilot study investigating the feasibility and safety of LPS Adsorber therapy...
December 8, 2016: Trials
https://www.readbyqxmd.com/read/27929242/community-acquired-pneumonia-in-adults-diagnosis-and-management
#4
Alexander Kaysin, Anthony J Viera
Community-acquired pneumonia is a leading cause of death. Risk factors include older age and medical comorbidities. Diagnosis is suggested by a history of cough, dyspnea, pleuritic pain, or acute functional or cognitive decline, with abnormal vital signs (e.g., fever, tachycardia) and lung examination findings. Diagnosis should be confirmed by chest radiography or ultrasonography. Validated prediction scores for pneumonia severity can guide the decision between outpatient and inpatient therapy. Using procalcitonin as a biomarker for severe infection may further assist with risk stratification...
November 1, 2016: American Family Physician
https://www.readbyqxmd.com/read/27928779/how-antibiotics-should-be-prescribed-to-hospitalized-elderly-patients-with-community-acquired-pneumonia
#5
Forest W Arnold
Elderly patients hospitalized with community-acquired pneumonia (CAP) should be administered antimicrobials in the emergency department prior to transfer to the ward or intensive care unit (ICU). For ward patients, a β-lactam with a macrolide or a respiratory fluoroquinolone alone should be given to cover typical and atypical pathogens. For ICU patients, a β-lactam with either a macrolide or a fluoroquinolone should be given. Other regimens are indicated if methicillin-resistant Staphylococcus aureus or Pseudomonas aeruginosa is a concern...
December 7, 2016: Drugs & Aging
https://www.readbyqxmd.com/read/27928632/ventriculostomy-related-infections-in-subarachnoid-hemorrhage-patients-a-retrospective-study-of-incidence-etiology-and-antimicrobial-therapy
#6
Johan Widén, Britt-Marie Eriksson, Elisabeth Ronne-Engström, Per Enblad, Gabriel Westman
BACKGROUND: This study was performed to investigate the incidence and etiology of ventriculostomy-related infections (VRIs) in patients with subarachnoid hemorrhage (SAH) and to assess adherence to local clinical guidelines regarding empirical antimicrobial therapy and diagnostic routines. METHODS: A total of 191 consecutive SAH patients treated in the neuro-intensive care unit of Uppsala University Hospital between 2010 and 2013 were included retrospectively. Information regarding cerebrospinal fluid samples, bacterial cultures, ventriculostomy treatment, patient characteristics, and antibiotic treatment were collected from electronic patient records...
December 7, 2016: Acta Neurochirurgica
https://www.readbyqxmd.com/read/27927814/non-invasive-ventilation-in-acute-respiratory-failure-a-meta-analysis
#7
Yu-Jing Liu, Jing Zhao, Hui Tang
Non-invasive positive-pressure ventilation (NPPV) has assumed an important role in the management of respiratory failure because it provides ventilatory support without the need for an invasive airway. However, its effectiveness remains unclear. We performed this meta-analysis to investigate the utility of NPPV intervention in patients with acute respiratory failure (ARF). A comprehensive literature search identified 12 studies enrolling a total of 963 patients from Medline, PubMed, Cochrane and EMBASE databases that assessed the effectiveness of NPPV versus conventional mechanical ventilation and/or non-ventilation therapy in patients with ARF, irrespective of the underlying aetiology, as well as mortality rate and the length of intensive care unit (ICU) or hospital stay...
December 2016: Clinical Medicine: Journal of the Royal College of Physicians of London
https://www.readbyqxmd.com/read/27927037/clinical-hepatotoxicity-associated-with-antifungal-agents
#8
Ioannis Kyriakidis, Athanasios Tragiannidis, Silke München, Andreas H Groll
Invasive fungal diseases (IFDs) are a leading cause of morbidity and mortality among immunocompromised patients with bone marrow failure syndromes, hematological malignancies, hematopoietic stem cell transplantation (HSCT), those admitted in intensive care units (ICUs) and those with prolonged febrile neutropenia. IFDs occur in a setting of multiple morbidities and are associated with case fatality rates between 30 and 70%. Along with the development of classes and compounds, the last two decades have seen substantial improvements in the prevention and management of these infections and an overall increased use of antifungal agents...
December 7, 2016: Expert Opinion on Drug Safety
https://www.readbyqxmd.com/read/27925086/multidisciplinary-team-of-intensive-therapy-humanization-and-fragmentation-of-the-work-process
#9
Viviane Canhizares Evangelista, Thiago da Silva Domingos, Fernanda Paula Cerântola Siqueira, Eliana Mara Braga
Objective: to understand the meaning of humanized care in intensive care units considering the experience of the multidisciplinary team. Method: descriptive and exploratory qualitative research. For this purpose, we conducted semi-structured interviews with 24 professionals of the heath-care team, and, after transcription, we organized the qualitative data according to content analysis. Results: from two main categories, we were able to understand that humanized care is characterized in the actions of health-care: effective communication, team work, empathy, singularity, and integrality; and mischaracterized in the management processes, specifically in the fragmentation of the work process and health-care, in the precarious work conditions, and in differing conceptual aspects of the political proposal of humanization...
November 2016: Revista Brasileira de Enfermagem
https://www.readbyqxmd.com/read/27924203/the-effects-of-etomidate-and-midazolam-on-adipose-tissue-derived-mesenchymal-stem-cell-proliferation
#10
Ho Park, Kyoungho Ryu, Yun-Hong Kim, Won-Jun Choi, Dongchan Ko
BACKGROUND: Stem cell therapy using adipose tissue-derived mesenchymal stem cells (ADSCs), which are capable of multipotent differentiation, is currently being investigated in the field of tissue regeneration and the treatment of patients in intensive care units. It is known that type-A γ-aminobutyric acid (GABAA) receptor activity has an influence on stem cell proliferation. Thus, we investigated the effects of the clinically available GABAA receptor agonists, etomidate and midazolam, on ADSC proliferation measured by the cell counting kit-8 assay...
December 2016: Korean Journal of Anesthesiology
https://www.readbyqxmd.com/read/27924176/our-clinical-experience-of-self-expanding-metal-stent-for-malignant-central-airway-obstruction
#11
Akash Verma, Chee Kiang Phua, Qiu Mei Wu, Wen Yuan Sim, Audrey Wee Chuan Rui, Soon Keng Goh, Benjamin Ho, Ai Ching Kor, Andrew S Y Wong, Albert Y H Lim, Dessmon Y H Tai, John Abisheganaden
BACKGROUND: We studied the safety, effectiveness, and limitations of airway stenting using self-expanding metal stent (SEMS) in patients with malignant central airway obstruction (CAO). METHODS: A retrospective review of records of patients undergoing SEMS placement for malignant CAO during year 2013 - 2014 was done. RESULTS: Sixteen patients (11 males and five females) underwent SEMS placement for malignant CAO. Median (range) age was 66 (54 - 78) years...
January 2017: Journal of Clinical Medicine Research
https://www.readbyqxmd.com/read/27923376/immunomodulation-after-ischemic-stroke-potential-mechanisms-and-implications-for-therapy
#12
REVIEW
Cynthia Santos Samary, Paolo Pelosi, Pedro Leme Silva, Patricia Rieken Macedo Rocco
Brain injuries are often associated with intensive care admissions, and carry high morbidity and mortality rates. Ischemic stroke is one of the most frequent causes of injury to the central nervous system. It is now increasingly clear that human stroke causes multi-organ systemic disease. Brain inflammation may lead to opposing local and systemic effects. Suppression of systemic immunity by the nervous system could protect the brain from additional inflammatory damage; however, it may increase the susceptibility to infection...
December 7, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27923227/optimal-role-of-the-nephrologist-in-the-intensive-care-unit
#13
D J Askenazi, Michael Heung, Michael J Connor, Rajit K Basu, Jorge Cerdá, Kent Doi, Jay L Koyner, Azra Bihorac, Ladan Golestaneh, Anitha Vijayan, Mark D Okusa, Sarah Faubel
As advances in Critical Care Medicine continue, critically ill patients are surviving despite the severity of their illness. The incidence of acute kidney injury (AKI) has increased, and its impact on clinical outcomes as well as medical expenditures has been established. The role, indications and technological advancements of renal replacement therapy (RRT) have evolved, allowing more effective therapies with less complications. With these changes, Critical Care Nephrology has become an established specialty, and ongoing collaborations between critical care physicians and nephrologist have improved education of multi-disciplinary team members and patient care in the ICU...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27922256/statins-in-critical-care-to-give-or-not-to-give
#14
Amr S Omar, Samy Hanoura, Haifa M Aljanubi, Ahmed Mahfouz
Owing to statin's immune modulatory, anti-inflammatory, antioxidant, antithrombotic and endothelial function actions, they are widely used in the critical care settings in diverse disease scenarios. We aim to explore the evidence to globalize the utilization of statins in the intensive care practice for different indications. We carried out a search of the PubMed, Cochrane and EMBASE databases up to January 2016. We included review articles, meta-analyses, and original trials on the effects of statin therapy in the intensive care unit (ICU) combining the following MESH terms: 'satins', 'intensive care, 'cardiac surgery', 'sepsis', 'acute respiratory distress syndrome' 'pneumonia', subarachnoid hemorrhage', traumatic brain injury and 'critical illness'...
December 6, 2016: Minerva Anestesiologica
https://www.readbyqxmd.com/read/27922250/an-unusual-complication-of-endotracheal-intubation-ingestion-of-a-bulb-in-a-premature-neonate
#15
Özmert M A Özdemir, Ali Koçyiğit, Cem Çiçek, Uğur Koltuksuz, Hacer Ergin
Endotracheal intubation is a common daily procedure used for sustaining life in premature and term neonates in the neonatal intensive care unit. This procedure can be associated with some iatrogenic complications. One of these complications is ingesting a laryngoscope light bulb, and it is an extremely rare complication in neonates. The consequences of ingestion or aspiration may be serious and life-threatening. Herein, a male premature neonate, ingested a laryngoscope light bulb during endotracheal intubation because of surfactant replacement therapy, is reported...
2016: Turkish Journal of Pediatrics
https://www.readbyqxmd.com/read/27920974/a-case-report-of-malignant-obesity-hypoventilation-syndrome-a-weighty-problem-in-our-icus
#16
Michael Tatusov, Joshua J Joseph, Brian M Cuneo
INTRODUCTION: The obesity epidemic is reflected by increasing numbers of morbidly obese patients being admitted to intensive care units (ICUs). These are complicated patients whose care involves many diagnostic and treatment challenges. We are presenting a fatal case of super obesity, hypoventilation, and multi-organ failure known as malignant obesity hypoventilation syndrome (MOHS). CASE PRESENTATION: 35 year old African American gentleman with a body mass index (BMI) of 115 kg/m(2) presented to the hospital with respiratory distress...
2017: Respiratory Medicine Case Reports
https://www.readbyqxmd.com/read/27920416/re-evaluating-the-inhibition-of-stress-erosions-revise-a-protocol-for-pilot-randomized-controlled-trial
#17
Waleed Alhazzani, Gordon Guyatt, John C Marshall, Richard Hall, John Muscedere, Francois Lauzier, Lehana Thabane, Mohammed Alshahrani, Shane W English, Yaseen M Arabi, Adam M Deane, Tim Karachi, Bram Rochwerg, Simon Finfer, Nick Daneman, Nicole Zytaruk, Diane Heel-Ansdell, Deborah Cook, On Behalf Of
INTRODUCTION: Clinicians routinely administer stress ulcer prophylaxis to mechanically ventilated patients in the intensive care unit (ICU), most commonly prescribing proton pump inhibitors (PPIs). However, the incidence of gastrointestinal (GI) bleeding from stress ulceration is low and recent observational studies suggest these agents may increase infections. Therefore, a large randomized clinical trial (RCT) is needed to inform modern practice. The aim of this multicenter pilot trial is to determine the feasibility of performing a large RCT to investigate the efficacy and safety of withholding intravenous pantoprazole...
November 2016: Annals of Saudi Medicine
https://www.readbyqxmd.com/read/27919645/empirical-mono-versus-combination-antibiotic-therapy-in-adult-intensive-care-patients-with-severe-sepsis-a-systematic-review-with-meta-analysis-and-trial-sequential-analysis
#18
REVIEW
Fredrik Sjövall, Anders Perner, Morten Hylander Møller
OBJECTIVES: To assess benefits and harms of empirical mono- vs. combination antibiotic therapy in adult patients with severe sepsis in the intensive care unit (ICU). METHODS: We performed a systematic review according to the Cochrane Collaboration methodology, including meta-analysis, risk of bias assessment and trial sequential analysis (TSA). We included randomised clinical trials (RCT) assessing empirical mono-antibiotic therapy versus a combination of two or more antibiotics in adult ICU patients with severe sepsis...
December 2, 2016: Journal of Infection
https://www.readbyqxmd.com/read/27919270/delayed-hyperbaric-oxygen-therapy-for-air-emboli-after-open-heart-surgery-case-report-and-review-of-a-success-story
#19
Eva Niyibizi, Guillaume Elyes Kembi, Claude Lae, Rodrigue Pignel, Tornike Sologashvili
BACKGROUND: The current case describes a rare diagnosis of iatrogenic air emboli after elective cardiopulmonary bypass that was successfully treated with delayed hyperbaric oxygen therapy, with good clinical evolution in spite of rare complications. CASE PRESENTATION: A 35 years old male was admitted to the intensive care unit (ICU) for post-operative management after being placed on cardiopulmonary bypass (CPB) for an elective ventricular septal defect closure and aortic valvuloplasty...
December 5, 2016: Journal of Cardiothoracic Surgery
https://www.readbyqxmd.com/read/27918377/utility-of-emergency-department-observation-units-for-neurologically-intact-children-with-head-ct-abnormalities-secondary-to-acute-closed-head-injury
#20
Roxanna Lefort, Jill V Hunter, Andrea T Cruz, A Chantal Caviness, Thomas G Luerssen, Aderonke Adekunle-Ojo
OBJECTIVE: The aim of the study was to evaluate the utility of the emergency department observation unit (EDOU) for neurologically intact children with closed head injuries (CHIs) and computed tomography (CT) abnormalities. METHODS: A retrospective cohort study of children aged 0 to 18 years with acute CHI, abnormal head CT, and a Glasgow Coma Scales score of 14 or higher admitted to the EDOU of a tertiary care children's hospital from 2007 to 2010. Children with multisystem trauma, nonaccidental trauma, and previous neurosurgical or coagulopathic conditions were excluded...
December 1, 2016: Pediatric Emergency Care
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