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https://www.readbyqxmd.com/read/27843206/role-of-systemic-chemotherapy-in-metastatic-hormone-sensitive-prostate-cancer
#1
REVIEW
Niraj Shenoy, Manish Kohli
INTRODUCTION: Patients with metastatic hormone sensitive prostate cancer (mHSPC) have traditionally been treated with androgen deprivation therapy (ADT). Recently, there has been a demonstration of a survival benefit with the addition of docetaxel to ADT from three large randomized controlled trials. This review summarizes these trials, draws comparisons between the trials, and attempts to provide critical evidence-based recommendation on the role of docetaxel in mHSPC. METHODS: Of the two published (GETUG-AFU, Chemo-Hormonal therapy vs...
October 2016: Indian Journal of Urology: IJU: Journal of the Urological Society of India
https://www.readbyqxmd.com/read/27825364/mid-regional-pro-adrenomedullin-mr-proadm-a-marker-of-positive-fluid-balance-in-critically-ill-patients-results-of-the-envol-study
#2
Bernard Vigué, Pierre-Etienne Leblanc, Frédérique Moati, Eric Pussard, Hussam Foufa, Aurore Rodrigues, Samy Figueiredo, Anatole Harrois, Jean-Xavier Mazoit, Homa Rafi, Jacques Duranteau
BACKGROUND: The optimal control of blood volume without fluid overload is a main challenge in the daily care of intensive care unit (ICU) patients. Accordingly this study focused on the identification of biomarkers to help characterize fluid overload status. METHODS: Sixty-seven patients were studied from ICU admission to day 7 (D7). Blood and urine samples were taken daily and sodium and water balance strictly calculated resulting in a total cumulative assessment of ∆Na(+) and ∆H2O...
November 9, 2016: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/27822078/acute-kidney-injury-adjusted-to-volume-status-in-critically-ill-patients-recognition-of-delayed-diagnosis-restaging-and-associated-outcomes
#3
Harout Yacoub, Leen Khoury, Youssef El Douaihy, Chadi Salmane, Jeanne Kamal, Marc Saad, Patricia Nasr, Jared Radbel, Elie El-Charabaty, Suzanne El-Sayegh
Critically ill patients receive a significant amount of fluids leading to a positive fluid balance; this dilutes serum creatinine resulting in an overestimated glomerular filtration rate. The goal of our study is to identify undiagnosed or underestimated acute kidney injury (AKI) in the intensive care unit (ICU). It will also identify the morbidity and mortality associated with an underestimated AKI. We reviewed records of patients admitted to our institution (Staten Island University Hospital) between 2012 and 2013 for more than 2 days...
2016: International Journal of Nephrology and Renovascular Disease
https://www.readbyqxmd.com/read/27783380/common-pitfalls-in-point-of-care-ultrasound-a-practical-guide-for-emergency-and-critical-care-physicians
#4
REVIEW
Pablo Blanco, Giovanni Volpicelli
BACKGROUND: Point-of-care ultrasonography (POCUS) is a widely used tool in emergency and critical care settings, useful in the decision-making process as well as in interventional guidance. While having an impressive diagnostic accuracy in the hands of highly skilled operators, inexperienced practitioners must be aware of some common misinterpretations that may lead to wrong decisions at the bedside. OBJECTIVES: This article provides a revision list of common POCUS misdiagnoses usually found in practice and offers useful tips to recognize and avoid them...
December 2016: Critical Ultrasound Journal
https://www.readbyqxmd.com/read/27755068/clinical-practice-guidelines-for-sustained-neuromuscular-blockade-in-the-adult-critically-ill-patient
#5
Michael J Murray, Heidi DeBlock, Brian Erstad, Anthony Gray, Judi Jacobi, Che Jordan, William McGee, Claire McManus, Maureen Meade, Sean Nix, Andrew Patterson, M Karen Sands, Richard Pino, Ann Tescher, Richard Arbour, Bram Rochwerg, Catherine Friederich Murray, Sangeeta Mehta
OBJECTIVE: To update the 2002 version of "Clinical practice guidelines for sustained neuromuscular blockade in the adult critically ill patient." DESIGN: A Task Force comprising 17 members of the Society of Critical Medicine with particular expertise in the use of neuromuscular-blocking agents; a Grading of Recommendations Assessment, Development, and Evaluation expert; and a medical writer met via teleconference and three face-to-face meetings and communicated via e-mail to examine the evidence and develop these practice guidelines...
November 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/27686439/-the-correlation-between-optic-nerve-sheath-diameter-and-volume-status-in-patients-after-cardiac-surgery
#6
H Chen, X T Wang, X Ding, H M Zhang, H Zhao, Y G Chao, W He, D W Liu
Objective: To investigate the relationship between optic nerve sheath diameter (ONSD) and volume status of patients after cardiac surgery. Methods: A total of consecutive 56 patients who were treated in Critical Care Unit in Peking Union Medical College Hospital after open heart surgery from January to August 2015 were screened in this study. Central venous pressure (CVP) and 72 h net fluid balance were monitored. ONSD and diameter of inferior vena cava (IVC) were measured by ultrasound. Results: A total of 44 patients were finally included in the study...
October 1, 2016: Zhonghua Nei Ke za Zhi [Chinese Journal of Internal Medicine]
https://www.readbyqxmd.com/read/27604182/measurement-of-the-hematocrit-using-paper-based-microfluidic-devices
#7
Samuel B Berry, Syrena C Fernandes, Anjali Rajaratnam, Nicholas S DeChiara, Charles R Mace
The quantification of blood cells provides critical information about a patient's health status. Sophisticated analytical equipment, such as hematology analyzers, have been developed to perform these measurements, but limited-resource settings often lack the infrastructure required to purchase, operate, and maintain instrumentation. To address these practical challenges, paper-based microfluidic devices have emerged as a platform to develop diagnostic assays specifically for use at the point-of-care. To date, paper-based microfluidic devices have been used broadly in diagnostic assays that apply immunoassay, clinical chemistry, and electrochemistry techniques...
October 7, 2016: Lab on a Chip
https://www.readbyqxmd.com/read/27570926/differences-in-the-quality-of-pediatric-resuscitative-care-across-a-spectrum-of-emergency-departments
#8
Marc Auerbach, Travis Whitfill, Marcie Gawel, David Kessler, Barbara Walsh, Sandeep Gangadharan, Melinda Fiedor Hamilton, Brian Schultz, Akira Nishisaki, Khoon-Yen Tay, Megan Lavoie, Jessica Katznelson, Robert Dudas, Janette Baird, Vinay Nadkarni, Linda Brown
Importance: The quality of pediatric resuscitative care delivered across the spectrum of emergency departments (EDs) in the United States is poorly described. In a recent study, more than 4000 EDs completed the Pediatric Readiness Survey (PRS); however, the correlation of PRS scores with the quality of simulated or real patient care has not been described. Objective: To measure and compare the quality of resuscitative care delivered to simulated pediatric patients across a spectrum of EDs and to examine the correlation of PRS scores with quality measures...
October 1, 2016: JAMA Pediatrics
https://www.readbyqxmd.com/read/27484681/fluid-overload-in-the-icu-evaluation-and-management
#9
Rolando Claure-Del Granado, Ravindra L Mehta
BACKGROUND: Fluid overload is frequently found in acute kidney injury patients in critical care units. Recent studies have shown the relationship of fluid overload with adverse outcomes; hence, manage and optimization of fluid balance becomes a central component of the management of critically ill patients. DISCUSSION: In critically ill patients, in order to restore cardiac output, systemic blood pressure and renal perfusion an adequate fluid resuscitation is essential...
August 2, 2016: BMC Nephrology
https://www.readbyqxmd.com/read/27472686/hand-carried-ultrasound-use-in-clinical-nephrology-case-report
#10
Kathryn D Winters, Stephanie Toth-Manikowski, Carol Martire, Tariq Shafi
BACKGROUND: Correctly assessing and managing volume status are critical elements of daily care for patients managed by nephrologists. However, intravascular volume is difficult to assess by physical examination alone. METHODS: We present vignettes illustrating the potential for using hand-carried ultrasound (HCU) to improve volume assessment in common clinical scenarios faced by the renal consultant in the hospital setting. These include patients with acute kidney injury and patients treated with hemodialysis...
July 2016: Medicine (Baltimore)
https://www.readbyqxmd.com/read/27416064/high-mortality-in-severe-sepsis-and-septic-shock-patients-with-do-not-resuscitate-orders-in-east-asia
#11
Chun-Ta Huang, Yu-Chung Chuang, Yi-Ju Tsai, Wen-Je Ko, Chong-Jen Yu
BACKGROUND: Severe sepsis is a potentially deadly illness and always requires intensive care. Do-not-resuscitate (DNR) orders remain a debated issue in critical care and limited data exist about its impact on care of septic patients, particularly in East Asia. We sought to assess outcome of severe sepsis patients with regard to DNR status in Taiwan. METHODS: A retrospective cohort study was conducted in intensive care units (ICUs) between 2008 and 2010. All severe sepsis patients were included for analysis...
2016: PloS One
https://www.readbyqxmd.com/read/27313844/fluid-resuscitation-practice-patterns-in-intensive-care-units-of-the-usa-a-cross-sectional-survey-of-critical-care-physicians
#12
Timothy E Miller, Martin Bunke, Paul Nisbet, Charles S Brudney
BACKGROUND: Fluid resuscitation is a cornerstone of intensive care treatment, yet there is a lack of agreement on how various types of fluids should be used in critically ill patients with different disease states. Therefore, our goal was to investigate the practice patterns of fluid utilization for resuscitation of adult patients in intensive care units (ICUs) within the USA. METHODS: We conducted a cross-sectional online survey of 502 physicians practicing in medical and surgical ICUs...
2016: Perioperative Medicine
https://www.readbyqxmd.com/read/27163762/nephrology-update-end-stage-renal-disease-and-renal-replacement-therapy
#13
REVIEW
Niraj Desai, Mahboob Rahman
End-stage renal disease (ESRD) is associated with high rates of morbidity and mortality, and increased health care use. Optimal management of patients with ESRD requires close collaboration among primary care physicians, nephrology subspecialists, and other subspecialists. Critical issues for the family physician include helping patients transition from chronic kidney disease to ESRD, recognizing and managing common issues in patients receiving dialysis or after kidney transplantation, and understanding palliative care for patients with ESRD...
May 2016: FP Essentials
https://www.readbyqxmd.com/read/27156756/diagnosis-and-treatment-of-hyponatraemia
#14
REVIEW
S G Ball, Zohaib Iqbal
Hyponatraemia is the most common electrolyte abnormality encountered by physicians in the hospital setting. It is associated with increased mortality and length of hospital stay. However, the basis of the relationship of hyponatraemia with clinical outcome is not clear. Doubt remains as to whether the relationship is causal. It may reflect the association of two independent variables both of which are linked with disease severity. Serum sodium concentration is regulated through integrated neuro-humeral mechanisms that overlap with those regulating circulating volume...
March 2016: Best Practice & Research. Clinical Endocrinology & Metabolism
https://www.readbyqxmd.com/read/27113689/critical-care-ultrasound-a-review-for-practicing-nephrologists
#15
REVIEW
Jennifer G Wilson, Kristine E W Breyer
The use of point-of-care ultrasound in the intensive care unit, both for diagnostic and procedural purposes, has rapidly proliferated, and evidence supporting its use is growing. Conceptually, critical care ultrasound (CCUS) should be considered an extension of the physical examination and should not be considered a replacement for formal echocardiography or radiology-performed ultrasound. Several CCUS applications are of particular relevance to nephrologists, including focused renal ultrasound in patients at high risk for urinary tract obstruction, real-time ultrasound guidance and verification during the placement of central venous catheters, and ultrasound-augmented assessment of shock and volume status...
May 2016: Advances in Chronic Kidney Disease
https://www.readbyqxmd.com/read/27031378/curriculum-development-and-evaluation-of-a-hemodynamic-critical-care-ultrasound-a-systematic-review-of-the-literature
#16
Hussein D Kanji, Jessica L McCallum, Kapil M Bhagirath, Andrew S Neitzel
OBJECTIVE: The application of ultrasound to assess a patient's cardiac function and volume status is becoming commonplace in the practice of critical care. These skills have been taught through varying curricula; however, no consensus on the optimal curriculum has been established. The purpose of this systematic review is to evaluate the literature regarding critical care ultrasound curriculum development and evaluation. DATA SOURCES: Studies were identified using MEDLINE, Embase, CINAHL, PsycInfo, the Cochrane Center Register of Controlled Trials, and ERIC according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines through June 2014...
August 2016: Critical Care Medicine
https://www.readbyqxmd.com/read/26945328/pediatric-cardiac-intensive-care-society-2014-consensus-statement-pharmacotherapies-in-cardiac-critical-care-fluid-management
#17
Amy N McCammond, David M Axelrod, David K Bailly, E Zachary Ramsey, John M Costello
OBJECTIVE: In this Consensus Statement, we review the etiology and pathophysiology of fluid disturbances in critically ill children with cardiac disease. Clinical tools used to recognize pathologic fluid states are summarized, as are the mechanisms of action of many drugs aimed at optimal fluid management. DATA SOURCES: The expertise of the authors and a review of the medical literature were used as data sources. DATA SYNTHESIS: The authors synthesized the data in the literature in order to present clinical tools used to recognize pathologic fluid states...
March 2016: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/26882226/fluid-management-in-acute-kidney-injury
#18
Chiao-Lin Chuang
The goal of fluid therapy in critical care medicine is to restore hemodynamic stability and vital organ perfusion while avoiding interstitial edema. Acute kidney injury (AKI) is a common complication in critically ill patients. Decisions regarding fluid management in critically ill patients with AKI are difficult, as these patients often have accompanying oliguria as well as body fluid overload. Both hypovolemia and volume overload are associated with increased morbidity and mortality in critical care patients; therefore, accurate assessment of the intravascular volume status as well as the response to fluid replacement remains one of the most challenging and important issues for clinicians in daily practice...
2016: Contributions to Nephrology
https://www.readbyqxmd.com/read/26829083/does-6-month-home-caregiver-supervised-physiotherapy-improve-post-critical-care-outcomes-a-randomized-controlled-trial
#19
Michele Vitacca, Luca Barbano, Fabio Vanoglio, Alberto Luisa, Palmira Bernocchi, Amerigo Giordano, Mara Paneroni
OBJECTIVE: This study aims to determine whether a 6-month home physiotherapy program can improve outcomes in critical care survivors. DESIGN: Forty-eight consecutive patients were randomized. The treatment group underwent 2 sessions/day of breathing retraining and bronchial hygiene, physical activity (mobilization, sit-to-stand gait, limb strengthening), and exercise re-conditioning whereas controls underwent standard care. Maximum inspiratory/expiratory pressures (MIP/MEP), forced volumes, blood gases, dyspnea, respiratory rate, disability, peripheral force measurements, perceived health status (Euroquol-5D), patient adherence/satisfaction, safety, and costs were assessed...
August 2016: American Journal of Physical Medicine & Rehabilitation
https://www.readbyqxmd.com/read/26791920/-assessment-of-energy-metabolism-and-nutritional-supply-in-children-with-mechanical-ventilation
#20
Jian Ji, Suyun Qian, Jie Yan
OBJECTIVE: To determine the resting energy expenditure on mechanical ventilation in pediatric intensive care unit (PICU) by indirect calorimetry, and analyze the distribution of metabolic states. The nutrition supply was assessed according to the resting energy expenditure. METHOD: An observational study which was held in PICU of Beijing Children's Hospital from November 2013 to April 2014. Critically ill children with mechanical ventilation were enrolled in this study...
January 2016: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
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