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Critical care medicine

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https://www.readbyqxmd.com/read/28633904/clinical-characteristics-of-type-a-acute-aortic-dissection-with-symptom-of-the-central-nervous-system
#1
Yuji Shono, Tomohiko Akahoshi, Satomi Mezuki, Kenta Momii, Noriyuki Kaku, Jun Maki, Kentaro Tokuda, Tetsuro Ago, Takanari Kitazono, Yoshihiko Maehara
BACKGROUND AND PURPOSE: Accurate diagnosis of acute aortic dissection (AAD) is sometimes difficult because of accompanying central nervous system (CNS) symptoms. The purpose of this study was to investigate the clinical characteristics of Type A AAD (TAAAD) with CNS symptoms. METHODS: We retrospectively reviewed the medical records of 8403 patients ambulanced to our emergency and critical care center between April 2009 and May 2014. RESULTS: We identified 59 TAAAD patients for the analysis (mean age, 67...
June 6, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28631089/targeted-temperature-management-in-the-icu-guidelines-from-a-french-expert-panel
#2
REVIEW
Alain Cariou, Jean-François Payen, Karim Asehnoune, Gerard Audibert, Astrid Botte, Olivier Brissaud, Guillaume Debaty, Sandrine Deltour, Nicolas Deye, Nicolas Engrand, Gilles Francony, Stéphane Legriel, Bruno Levy, Philippe Meyer, Jean-Christophe Orban, Sylvain Renolleau, Bernard Vigue, Laure De Saint Blanquat, Cyrille Mathien, Lionel Velly
Over the recent period, the use of induced hypothermia has gained an increasing interest for critically ill patients, in particular in brain-injured patients. The term "targeted temperature management" (TTM) has now emerged as the most appropriate when referring to interventions used to reach and maintain a specific level temperature for each individual. TTM may be used to prevent fever, to maintain normothermia, or to lower core temperature. This treatment is widely used in intensive care units, mostly as a primary neuroprotective method...
December 2017: Annals of Intensive Care
https://www.readbyqxmd.com/read/28628057/advancing-value-based-medicine-why-integrating-functional-outcomes-with-clinical-measures-is-critical-to-our-health-care-future
#3
Kathryn Mueller, Doris Konicki, Paul Larson, T Warner Hudson, Charles Yarborough
No abstract text is available yet for this article.
April 2017: Journal of Occupational and Environmental Medicine
https://www.readbyqxmd.com/read/28627845/efficacy-of-interprofessionnality-evidence-and-challenges
#4
Valérie Santschi, Philippe Germanier, Joëlle Tischhauser, Nicolas Senn, Alain Pecoud
Skillmix is often proposed as a measure to address the growing needs of an aging population with its expected increase in chronic diseases. This article reports on a symposium on interprofessional collaboration which took place in the canton of Valais in Switzerland. Reviews of the literature on interprofessional collaboration show evidence in favor of the effectiveness of having interactions between physicians, nurses, pharmacists and physiotherapists. A critical analysis of different forms of coordinated care within family medicine supports the effectiveness of these approaches...
May 2017: Revue Médicale Suisse
https://www.readbyqxmd.com/read/28625495/assessing-the-effect-of-an-intensive-2-week-surgical-training-and-innovation-program-for-high-school-students
#5
Brian Labadie, Roshan M Patel, Jessica Gandy Labadie, Christina Hwang, Zhamshid Okhunov, Jaime Landman
OBJECTIVE: The summer surgery program (SSP) was founded in 2012 as an educational program for students at the critical juncture between high school and college to engender interest in medicine, science, and innovation. This program has a distinct emphasis on innovation and problem solving based on real-life operative challenges identified by students during surgical observation in the operating room. The effect of the SSP regarding postsecondary education and career goals was evaluated by participants using a follow-up questionnaire...
June 15, 2017: Journal of Surgical Education
https://www.readbyqxmd.com/read/28625256/-comparison-of-effect-of-norepinephrine-and-terlipressin-on-patients-with-ards-combined-with-septic-shock-a-prospective-single-blind-randomized-controlled-trial
#6
Zhi Chen, Ping Zhou, Yuanhua Lu, Chunli Yang
OBJECTIVE: To approach the effect of different vasopressor on hemodynamics, volume responsiveness, fluid volume balance, renal function and prognosis in patients with acute respiratory distress syndrome (ARDS) complicated with septic shock. METHODS: A prospective single-blind randomized controlled trial was conducted. ARDS patients with septic shock admitted to the Department of Critical Care Medicine of Jiangxi Provincial People's Hospital from January 1st, 2015 to May 1st, 2016 were enrolled...
February 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625250/-fulminant-clostridium-difficile-colitis-new-challenges-in-critical-care-medicine
#7
Bin Liu
Fulminant Clostridium difficile colitis (FCDC) means severe Clostridium difficile colitis (CDC), which often manifested with severe diarrhea, fever, abdominal distention, electrolyte disorder, hypoalbuminemia, and it can lead to pseudo membrane colonitis, toxic megacolon, bowel perforation, septic shock, and multiple organ dysfunction. Now Clostridium difficile (CD) becomes one of the most important medical institutions related infectious pathogens. In particular, the recently discovered mutant CD strain NAP1/BI/ribotype 027 has high pathogenicity in the global epidemic and its outbreak...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28625248/-core-knowledge-and-skill-based-approach-to-subspecialty-construction-in-critical-intensive-care-medicine-with-distinct-chinese-peculiarity
#8
Lijun Wang, Fang Tian
With the rapid development of critical care medicine (CCM) in China, there are increases in the number of intensive care units (ICUs), the scale of one center ICU and the team. Subspecialty construction of CCM is of great concerns for personnel training as well as discipline development, and is currently one of the urgent problems that need to be resolved. Experience of CCM subspecialty construction from Europe and the United States is lacking and it is necessary to propose some opinions on innovation to construct CCM subspecialties with Chinese characteristics...
June 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28623949/hemoglobin-concentrations-and-rbc-transfusion-thresholds-in-patients-with-acute-brain-injury-an-international-survey
#9
Rafael Badenes, Mauro Oddo, José I Suarez, Massimo Antonelli, Jeffrey Lipman, Giuseppe Citerio, Fabio Silvio Taccone
BACKGROUND: The optimal hemoglobin (Hb) threshold at which to initiate red blood cell (RBC) transfusion in patients with acute brain injury is unknown. The aim of this survey was to investigate RBC transfusion practices used with these patients. METHODS: We conducted a web-based survey within various societies of critical care medicine for intensive care unit (ICU) physicians who currently manage patients with primary acute brain injury. RESULTS: A total of 868 responses were obtained from around the world, half of which (n = 485) were from European centers; 204 (24%) respondents had a specific certificate in neurocritical care, and most were specialists in anesthesiology or intensive care and had less than 15 years of practice experience...
June 17, 2017: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/28622010/-are-you-in-or-are-you-out-moral-appeals-to-the-public-in-organ-donation-poster-campaigns-a-multimodal-and-ethical-analysis
#10
Solveig L Hansen, Marthe I Eisner, Larissa Pfaller, Silke Schicktanz
Organ transplantation is a well-established practice in modern medicine. However, many countries, especially those with an opt-in regulation, face the problem of low donation numbers. Respective public campaigns attempt to increase the number of donors by swaying public opinion with the use of carefully selected bits of information. Germany serves as a case study for an opt-in country investing approximately €7.5 million/year in the distribution of respective campaigns. To address diverse populations, large-scale posters in various public spaces still display a multitude of moral messages for organ donation...
June 16, 2017: Health Communication
https://www.readbyqxmd.com/read/28620467/recent-advances-in-understanding-lung-function-development
#11
REVIEW
Erik Melén, Stefano Guerra
Recent years have witnessed critical contributions to our understanding of the determinants and long-term implications of lung function development. In this article, we review studies that have contributed to advances in understanding lung function development and its critical importance for lung health into adult life. In particular, we have focused on early life determinants that include genetic factors, perinatal events, environmental exposures, lifestyle, infancy lower respiratory tract infections, and persistent asthma phenotypes...
2017: F1000Research
https://www.readbyqxmd.com/read/28616666/the-role-of-psychosomatic-medicine-in-intensive-care-units
#12
REVIEW
Heidemarie Abrahamian, Diana Lebherz-Eichinger
Critically ill patients, their relatives, and intensive care staff are consistently exposed to stress. The principal elements of this exceptional burden are confrontation with a life-threatening disease, specific environmental conditions at the intensive care unit, and the social characteristics of intensive care medicine. The short- and long-term consequences of these stressors include a feeling of helplessness, distress, anxiety, depression, and even posttraumatic stress disorders. Not only the patients, but also their relatives and intensive care staff are at risk of developing such psychopathologies...
June 14, 2017: Wiener Medizinische Wochenschrift
https://www.readbyqxmd.com/read/28615640/differential-depression-of-neuronal-network-activity-by-midazolam-and-its-main-metabolite-1-hydroxymidazolam-in-cultured-neocortical-slices
#13
Monika Balk, Harald Hentschke, Uwe Rudolph, Bernd Antkowiak, Berthold Drexler
The benzodiazepine midazolam is widely used in critical care medicine. Midazolam has a clinically active metabolite, 1-hydroxymidazolam. The contribution of 1-hydroxymidazolam to the effects of midazolam is controversial. The aim of the current study was to compare the actions of midazolam and 1-hydroxymidazolam on network activity of cortical neurons. Midazolam depressed neuronal activity at a low concentration of 5 nM. When midazolam concentration was increased, it depressed neuronal discharge rates in a biphasic manner...
June 14, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28612657/improving-care-for-advanced-copd-through-practice-change-experiences-of-participation-in-a-canadian-spread-collaborative
#14
Jennifer Y Verma, Claudia Amar, Shannon Sibbald, Graeme M Rocker
Chronic obstructive pulmonary disease (COPD) is a leading cause of death, morbidity, and health-care spending. The Halifax, Nova Scotia-based INSPIRED COPD Outreach Program™ has proved highly beneficial for patients and the health-care system. With direct investment of <$1-million CAD, a pan-Canadian quality improvement collaborative (QIC) supported the spread of INSPIRED to 19 teams in the 10 Canadian provinces contingent upon participation in evaluation. The collaborative evaluation followed a mixed-methods summative approach relying on collated quantitative data, team documents, and surveys sent to core members of the 19 teams...
January 1, 2017: Chronic Respiratory Disease
https://www.readbyqxmd.com/read/28612089/the-intensive-care-delirium-research-agenda-a-multinational-interprofessional-perspective
#15
REVIEW
Pratik P Pandharipande, E Wesley Ely, Rakesh C Arora, Michele C Balas, Malaz A Boustani, Gabriel Heras La Calle, Colm Cunningham, John W Devlin, Julius Elefante, Jin H Han, Alasdair M MacLullich, José R Maldonado, Alessandro Morandi, Dale M Needham, Valerie J Page, Louise Rose, Jorge I F Salluh, Tarek Sharshar, Yahya Shehabi, Yoanna Skrobik, Arjen J C Slooter, Heidi A B Smith
Delirium, a prevalent organ dysfunction in critically ill patients, is independently associated with increased morbidity. This last decade has witnessed an exponential growth in delirium research in hospitalized patients, including those critically ill, and this research has highlighted that delirium needs to be better understood mechanistically to help foster research that will ultimately lead to its prevention and treatment. In this invited, evidence-based paper, a multinational and interprofessional group of clinicians and researchers from within the fields of critical care medicine, psychiatry, pediatrics, anesthesiology, geriatrics, surgery, neurology, nursing, pharmacy, and the neurosciences sought to address five questions: (1) What is the current standard of care in managing ICU delirium? (2) What have been the major recent advances in delirium research and care? (3) What are the common delirium beliefs that have been challenged by recent trials? (4) What are the remaining areas of uncertainty in delirium research? (5) What are some of the top study areas/trials to be done in the next 10 years? Herein, we briefly review the epidemiology of delirium, the current best practices for management of critically ill patients at risk for delirium or experiencing delirium, identify recent advances in our understanding of delirium as well as gaps in knowledge, and discuss research opportunities and barriers to implementation, with the goal of promoting an integrated research agenda...
June 13, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28609000/the-role-of-informatics-in-patient-centered-care-and-personalized-medicine
#16
Matthew G Hanna, Liron Pantanowitz
The practice of cytopathology has dramatically changed due to advances in genomics and information technology. Cytology laboratories have accordingly become increasingly dependent on pathology informatics support to meet the emerging demands of precision medicine. Pathology informatics deals with information technology in the laboratory, and the impact of this technology on workflow processes and staff who interact with these tools. This article covers the critical role that laboratory information systems, electronic medical records, and digital imaging plays in patient-centered personalized medicine...
June 2017: Cancer
https://www.readbyqxmd.com/read/28608711/recommended-reading-from-baylor-college-of-medicine-pulmonary-and-critical-care-medicine-fellows
#17
Van Hoang, Sarah K Medrek, Madhu Pendurthi, Christina C Kao, Amit D Parulekar
No abstract text is available yet for this article.
June 13, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28606207/utilizing-a-pediatric-disaster-coalition-model-to-increase-pediatric-critical-care-surge-capacity-in-new-york-city
#18
Michael Frogel, Avram Flamm, Mayer Sagy, Katharine Uraneck, Edward Conway, Michael Ushay, Bruce M Greenwald, Louisdon Pierre, Vikas Shah, Mohamed Gaffoor, Arthur Cooper, George Foltin
A mass casualty event can result in an overwhelming number of critically injured pediatric victims that exceeds the available capacity of pediatric critical care (PCC) units, both locally and regionally. To address these gaps, the New York City (NYC) Pediatric Disaster Coalition (PDC) was established. The PDC includes experts in emergency preparedness, critical care, surgery, and emergency medicine from 18 of 25 major NYC PCC-capable hospitals. A PCC surge committee created recommendations for making additional PCC beds available with an emphasis on space, staff, stuff (equipment), and systems...
June 13, 2017: Disaster Medicine and Public Health Preparedness
https://www.readbyqxmd.com/read/28604159/spiritual-care-in-the-intensive-care-unit-a-narrative-review
#19
Jim Q Ho, Christopher D Nguyen, Richard Lopes, Stephen C Ezeji-Okoye, Ware G Kuschner
Spiritual care is an important component of high-quality health care, especially for critically ill patients and their families. Despite evidence of benefits from spiritual care, physicians and other health-care providers commonly fail to assess and address their patients' spiritual care needs in the intensive care unit (ICU). In addition, it is common that spiritual care resources that can improve both patient outcomes and family member experiences are underutilized. In this review, we provide an overview of spiritual care and its role in the ICU...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28602557/recurrent-failings-of-medical-humanitarianism-intractable-ignored-or-just-exaggerated
#20
REVIEW
Sandro Colombo, Enrico Pavignani
Humanitarian health workers operate in dangerous and uncertain contexts, in which mistakes and failures are common, often have severe consequences, and are regularly repeated, despite being documented by many reviews. This Series paper aims to discuss the failures of medical humanitarianism. We describe why some of these recurrent failings, which are often not identified until much later, seem intractable: they are so entrenched in humanitarian action that they cannot be addressed by simple technical fixes...
June 7, 2017: Lancet
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