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Critical care medicine

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https://www.readbyqxmd.com/read/27923227/optimal-role-of-the-nephrologist-in-the-intensive-care-unit
#1
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/27919878/pharmacy-residency-training-measured-through-a-standardized-knowledge-test
#2
Amy N Thompson, Brian P McKinzie, Jason S Haney, Jean M Nappi, Nicole Pilch
PURPOSE: The use of a standardized knowledge test to assess postgraduate year 1 (PGY1) pharmacy residency training was evaluated. METHODS: This was a retrospective review of a prospectively administered exam. A bank of questions was developed by preceptors from each of the core rotation disciplines: general medicine (including ambulatory care and oncology), pediatrics, critical care (including transplantation), drug information, operations, practice management, and psychiatry...
December 15, 2016: American Journal of Health-system Pharmacy: AJHP
https://www.readbyqxmd.com/read/27916076/-daytime-hypercapnia-in-patients-with-obstructive-sleep-apnea-hypopnea-syndrome-in-han-and-uygur-nationality
#3
Z M He, X L Jiang, Piliqing Da, Z Ye, J P Li, Q L Zhang, Y Chen, J Shi, M Li, F Han
Objective: To evaluate the incidence and factors related to daytime hypercapnia in Han and Uygur patients with obstructive sleep apnea hypopnea syndrome (OSAHS). Methods: There were 221 patients with OSAHS (include 179 Han patients and 42 Uygur patients) in Sleep Center of Department of Respiratory and Critical Care Medicine of Karamay Central Hospital from 2015, Jan to Dec. All the patients underwent polysomnography (PSG), nocturnal oximetry, daytime blood gas analysis, pulmonary function test and Mouth occlusion pressure (P0...
November 29, 2016: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/27916027/-current-status-of-lung-transplantation-in-china-problems-and-perspectives
#4
X A Wang, G N Jiang
Despite rapid progress, clinical lung transplantation in China still lags far behind. A great challenge remains in donor lung utilization and perioperative medicine. It's really abnormal that we are so backward in lung transplantation when we have come up with the advanced world levels in thoracic surgery, pulmonology and critical care medicine. Our shortcomings were analyzed by comparing lung transplantation in China and in the advanced countries. The first problem is multidisciplinary teamwork. In the United States, a lung transplant team includes physician specialized in lung transplantation, thoracic surgeons, nurses, respiratory therapists and other specialists possibly needed...
December 1, 2016: Zhonghua Wai Ke za Zhi [Chinese Journal of Surgery]
https://www.readbyqxmd.com/read/27915328/critical-care-nephrology-a-multidisciplinary-approach
#5
Lilia Rizo-Topete, Claudio Ronco
Acute kidney injury (AKI) is a serious medical condition affecting millions of people. Patients in intensive care unit (ICU) who develop AKI have increased morbidity and mortality, prolonged length of stay in ICU and hospital and increased costs, especially when they require renal replacement therapy. In the latter case, morbidity and mortality increase further. In order to meet the needs of the critically ill patients, a multidisciplinary care team is required, combining the efforts of physicians and nurses from different disciplines as well as nephrologists and intensivists...
December 3, 2016: Blood Purification
https://www.readbyqxmd.com/read/27914760/update-clinical-use-of-plasma-lactate
#6
REVIEW
Íde Gillespie, Patricia G Rosenstein, Dez Hughes
Lactate is an essential, versatile metabolic fuel in cellular bioenergetics. In human emergency and critical care, lactate is used as a biomarker and therapeutic endpoint and evidence is growing in veterinary medicine supporting its clinical utility. Lactate production is a protective response providing ongoing cellular energy during tissue hypoperfusion or hypoxia and mitigating acidosis. Hence, hyperlactatemia is closely associated with disease severity but it is an epiphenomenon as the body attempts to protect itself...
November 30, 2016: Veterinary Clinics of North America. Small Animal Practice
https://www.readbyqxmd.com/read/27914157/-prevalence-of-dental-caries-in-type-1-diabetic-patients-treated-with-insulin-pump
#7
Rosana Garcia, Ana Coelho, Anabela Paula, Manuel Marques Ferreira, Francisco Caramelo, Luísa Barros, Carla Batista, Miguel Melo, Mário Jorge Silva, Eunice Carrilho
INTRODUCTION: Type 1 diabetes mellitus and oral health are strictly related on a reciprocal basis, and an increased susceptibility to a wide variety of oral diseases is recognised in these patients. The aim of the present study was to establish a relationship between the prevalence of dental caries in Type 1 diabetic patients treated with insulin pump and that of non-diabetic patients. MATERIAL AND METHODS: An observational clinical study of analytical and cross-sectional nature was conducted...
August 2016: Acta Médica Portuguesa
https://www.readbyqxmd.com/read/27913545/what-have-we-learned-from-large-population-studies-of-von-willebrand-disease
#8
Robert R Montgomery, Veronica H Flood
Von Willebrand factor (VWF) is a critical regulator of hemostatic processes, including collagen binding, platelet adhesion, and platelet aggregation. It also serves as a carrier protein to normalize plasma factor VIII synthesis, release, and survival. While VWF protein measurements by immunoassay are reasonably comparable between institutions, the measurement of VWF ristocetin cofactor activity (VWF:RCo) has significant variability. Other tests of VWF function, including collagen binding or platelet glycoprotein IIb-IIIa binding, are not universally available, yet these functional defects may cause major bleeding even with normal VWF antigen (VWF:Ag) and VWF:RCo assays...
December 2, 2016: Hematology—the Education Program of the American Society of Hematology
https://www.readbyqxmd.com/read/27913084/quality-of-communication-about-medicines-in-united-states-hospitals-a-national-retrospective-study
#9
Lauren Mullings, Jayashri Sankaranarayanan
BACKGROUND: Despite the benefits of improving transitions across care, literature is very limited on inpatient "Communication about Medicines" (ComMed) by staff across United States (U.S.) hospitals. OBJECTIVES: To evaluate ComMed quality variations by hospital characteristics. METHODS: In a cross-sectional, retrospective study of publicly available U.S. Medicare's Hospital Consumer Assessment of Health Care Plans Survey (HCAHPS) data (January 2013-September 2014), ComMed quality (high = above average/excellent vs...
October 26, 2016: Research in Social & Administrative Pharmacy: RSAP
https://www.readbyqxmd.com/read/27911567/recommended-reading-from-mayo-clinic-department-of-pulmonary-and-critical-care-medicine-fellows
#10
Natalya Azadeh, Ryan D Clay, Nicholas A Braus, Kannan Ramar
No abstract text is available yet for this article.
December 2, 2016: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/27908946/strategies-for-acute-and-critical-care-nurses-implementing-complementary-therapies-requested-by-patients-and-their-families
#11
Debra Kramlich
As consumer use of complementary and alternative medicine or modalities continues to increase in the United States, requests for these therapies in the acute and critical care setting will probably continue to expand in scope and frequency. Incorporation of complementary therapies in the plan of care is consistent with principles of patient- and family-centered care and collaborative decision-making and may provide a measure of relief for the distress of admission to an acute or critical care setting. An earlier article provided an overview of complementary and alternative therapies that nurses may encounter in their practices, with specific attention to implications for acute and critical care nurses...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27908942/the-need-for-an-effective-process-to-resolve-conflicts-over-medical-futility-a-case-study-and-analysis
#12
Jocelyn A Olmstead, Michael D Dahnke
The issue of medical futility requires a well-defined process in which both sides of the dispute can be heard and a resolution reached in a fair and ethical manner. Procedural approaches to medical futility cases provide all parties involved with a process-driven framework for resolving these disputes. Medical paternalism or the belief in the absolute rightness of the medical model will not serve to resolve these disputes. Although medical futility is first determined by medicine, in order for the determination to meet legal criteria, it must be subject to review...
December 2016: Critical Care Nurse
https://www.readbyqxmd.com/read/27902553/perspectives-and-uses-of-the-electronic-health-record-among-us-pediatricians-a-national-survey
#13
Julie W Doberne, Travis Redd, Daniel Lattin, Thomas R Yackel, Carl O Eriksson, Vishnu Mohan, Jeffrey A Gold, Joan S Ash, Michael F Chiang
Little is known about how existing electronic health records (EHRs) influence the practice of pediatric medicine. A total of 808 pediatricians participated in a survey about workflows using the EHR. The EHR was the most commonly used source of initial patient information. Seventy-two percent reported requiring between 2 and 10 minutes to complete an initial review of the EHR. Several moderately severe information barriers were reported regarding the display of information in the EHR. Pediatricians acquire information about new patients from EHRs more often than any other source...
January 2017: Journal of Ambulatory Care Management
https://www.readbyqxmd.com/read/27902520/rethinking-recovery-incorporating-holistic-nursing-perspectives-in-poststroke-care
#14
Frances Peterson-Burch, Karin Reuter-Rice, Taura L Barr
Stroke is a life-changing experience. Current treatments focus on treating the condition, rather than the whole person. The goal of this report was to communicate the benefits of a holistic approach to the treatment and recovery of stroke. Our intent was to begin a conversation to transform our approach to stroke care to focus on the whole person, body, mind, and spirit. Wellness approaches are fiscally responsible ways of providing holistic care for patients and their family members to help them achieve optimal individualized recovery...
January 2017: Holistic Nursing Practice
https://www.readbyqxmd.com/read/27899770/-universal-health-coverage-and-cancer-drugs-a-cost-effectiveness-perspective
#15
Ayako Fukuda, Ataru Igarashi
Japanese health system has been evaluated to be the closest to the ideal Universal Health Coverage(UHC)in the world. "Ideal UHC" is to ensure that all people could obtain the health services they need without suffering any financial hardship. However, maintaining current healthcare system, under which all medications are covered, is getting difficult due to the aging society and the existence of high-price drugs such as anti-cancer agents. Approval of OPDIVO(nivolumab)has raised the national discussion in Japan because of the possibility that the use of OPDIVO might collapse overall healthcare system...
November 2016: Gan to Kagaku Ryoho. Cancer & Chemotherapy
https://www.readbyqxmd.com/read/27892907/concierge-medicine-a-viable-business-model-for-some-physicians-of-the-future
#16
David P Paul, Michaeline Skiba
Concierge medicine is a medical management structure that has been in existence since the 1990s. Essentially, a typical concierge medical practice limits its number of patients and provides highly personalized attention that includes comprehensive annual physicals, same-day appointments, preventive and wellness care, and fast, 24/7 response time. Concierge medicine has become popular among both physicians and patients/consumers who are frustrated by the limitations imposed by managed care organizations. From many physicians' perspectives, concierge medicine offers greater autonomy, the opportunity to return to a more manageable patient load, and the chance to improve their incomes that have declined because of increasingly lowered reimbursements for their services...
January 2016: Health Care Manager
https://www.readbyqxmd.com/read/27890495/critical-care-guidelines-more-science-less-art
#17
EDITORIAL
The Lancet Respiratory Medicine
No abstract text is available yet for this article.
December 2016: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/27889825/a-critical-review-of-complementary-and-alternative-medicine-use-among-people-with-arthritis-a-focus-upon-prevalence-cost-user-profiles-motivation-decision-making-perceived-benefits-and-communication
#18
REVIEW
Lu Yang, David Sibbritt, Jon Adams
A critical review of complementary and alternative medicine (CAM) use among people with arthritis was conducted focusing upon prevalence and profile of CAM users as well as their motivation, decision-making, perceived benefits and communication with healthcare providers. A comprehensive search of peer-reviewed literature published from 2008 to 2015 was undertaken via CINAHL, Medline and AMED databases. The initial search identified 4331 articles, of which 49 articles met selection criteria. The review shows a high prevalence of CAM use (often multiple types and concurrent to conventional medical care) among those with arthritis which is not restricted to any particular geographic or social-economic status...
November 26, 2016: Rheumatology International
https://www.readbyqxmd.com/read/27886248/ultrasensitive-rapid-and-inexpensive-detection-of-dna-using-paper-based-lateral-flow-assay
#19
Miriam Jauset-Rubio, Markéta Svobodová, Teresa Mairal, Calum McNeil, Neil Keegan, Ayman Saeed, Mohammad Nooredeen Abbas, Mohammad S El-Shahawi, Abdulaziz S Bashammakh, Abdulrahman O Alyoubi, Ciara K O Sullivan
Sensitive, specific, rapid, inexpensive and easy-to-use nucleic acid tests for use at the point-of-need are critical for the emerging field of personalised medicine for which companion diagnostics are essential, as well as for application in low resource settings. Here we report on the development of a point-of-care nucleic acid lateral flow test for the direct detection of isothermally amplified DNA. The recombinase polymerase amplification method is modified slightly to use tailed primers, resulting in an amplicon with a duplex flanked by two single stranded DNA tails...
November 25, 2016: Scientific Reports
https://www.readbyqxmd.com/read/27884867/narrative-medicine-and-death-in-the-icu-word-clouds-as-a-visual-legacy
#20
Meredith Vanstone, Feli Toledo, France Clarke, Anne Boyle, Mita Giacomini, Marilyn Swinton, Lois Saunders, Melissa Shears, Nicole Zytaruk, Anne Woods, Trudy Rose, Tracey Hand-Breckenridge, Diane Heels-Ansdell, Shelley Anderson-White, Robert Sheppard, Deborah Cook
OBJECTIVE: The Word Cloud is a frequent wish in the 3 Wishes Project developed to nurture peace and ease the grieving process for dying critically ill patients. The objective was to examine whether Word Clouds can act as a heuristic approach to encourage a narrative orientation to medicine. Narrative medicine is an approach which can strengthen relationships, compassion and resilience. DESIGN: Word Clouds were created for 42 dying patients, and we interviewed 37 family members and 73 clinicians about their impact...
November 24, 2016: BMJ Supportive & Palliative Care
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