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Pain in critical care

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https://www.readbyqxmd.com/read/28099638/risk-factors-for-agitation-in-critically-ill-patients
#1
Thiago Miranda Lopes de Almeida, Luciano Cesar Pontes de Azevedo, Paulo Maurício Garcia Nosé, Flavio Geraldo Resende de Freitas, Flávia Ribeiro Machado
Objective: To evaluate the incidence of agitation in the first 7 days after intensive care unit admission, its risk factors and its associations with clinical outcomes. Methods: This single-center prospective cohort study included all patients older than 18 years with a predicted stay > 48 hours within the first 24 hours of intensive care unit admission. Agitation was defined as a Richmond Agitation Sedation Scale score ≥ +2, an episode of agitation or the use of a specific medication recorded in patient charts...
October 2016: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28098628/the-abcdef-bundle-science-and-philosophy-of-how-icu-liberation-serves-patients-and-families
#2
E Wesley Ely
Over the past 20 years, critical care has matured in a myriad of ways resulting in dramatically higher survival rates for our sickest patients. For millions of new survivors comes de novo suffering and disability called "the postintensive care syndrome." Patients with postintensive care syndrome are robbed of their normal cognitive, emotional, and physical capacity and cannot resume their previous life. The ICU Liberation Collaborative is a real-world quality improvement initiative being implemented across 76 ICUs designed to engage strategically the ABCDEF bundle through team- and evidence-based care...
February 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28090716/does-item-overlap-render-measured-relationships-between-pain-and-challenging-behaviour-trivial-results-from-a-multicentre-cross-sectional-study-in-13-german-nursing-homes
#3
Patrick Kutschar, Zsuzsa Bauer, Irmela Gnass, Jürgen Osterbrink
Several studies suggest that pain is a trigger for challenging behaviour in older adults with cognitive impairment. However, such measured relationships might be confounded due to item overlap as instruments share similar or identical items. The purpose of this study was to examine whether the frequently observed association between pain and challenging behaviour might be traced back to item overlap. This multicentre cross-sectional study was conducted in 13 nursing homes and examined pain (measure: Pain Assessment in Advanced Dementia Scale) and challenging behaviour (measure: Cohen-Mansfield Agitation Inventory) in 150 residents with severe cognitive impairment...
January 16, 2017: Nursing Inquiry
https://www.readbyqxmd.com/read/28069989/incomplete-diagnostic-follow-up-after-a-positive-colorectal-cancer-screening-test-a-systematic-review
#4
A R H Dalton
BACKGROUND: Colorectal cancer (CRC) screening using faecal occult blood or faecal immunological testing (FOBT/FIT) involves completion of a screening test-then if required a follow-up diagnostic test. METHODS: A systematic review, of EMBASE, MEDLINE, the Cochrane Library and Google Scholar, of studies up to 2016. Studies explored characteristics behind, reasons for and interventions to reduce incomplete diagnostic testing after a positive FOBT/FIT in CRC screening...
January 9, 2017: Journal of Public Health
https://www.readbyqxmd.com/read/28068948/women-s-preferences-for-childbirth-experiences-in-the-republic-of-ireland-a-mixed-methods-study
#5
Patricia Larkin, Cecily M Begley, Declan Devane
BACKGROUND: How women experience childbirth is acknowledged as critical to the postnatal wellbeing of mother and baby. However there is a knowledge deficit in identifying the important elements of these experiences in order to enhance care. This study elicits women's preferences for the most important elements of their childbirth experiences. METHODS: A mixed methods design was used. An initial qualitative phase (reported previously) was followed by a second quantitative one using a discrete choice experiment (DCE), which is reported on here...
January 10, 2017: BMC Pregnancy and Childbirth
https://www.readbyqxmd.com/read/28068863/an-exploratory-study-investigating-the-multidimensional-factors-impacting-the-health-and-well-being-of-young-adults-with-cerebral-palsy
#6
Susan E Sienko
BACKGROUND: For young adults with cerebral palsy, changes in psychological and social development, in conjunction with the progression of musculoskeletal deformities and the onset of secondary conditions, make the transition to adulthood a difficult developmental phase. Preliminary evidence shows that many of the physical impairments reported in adults with cerebral palsy begin during late adolescence; however, there is little information about prevalence of impairments and the combined role impairments, psychological and social factors have on the health and well-being of young adults with cerebral palsy...
January 9, 2017: Disability and Rehabilitation
https://www.readbyqxmd.com/read/28066556/does-the-combination-use-of-two-pain-assessment-tools-have-a-synergistic-effect
#7
EDITORIAL
Takeshi Suzuki
Pain management is a very important aspect in the intensive care unit (ICU), as adequate pain control has been shown to be associated with better clinical outcomes in critically ill patients. A Numerical Rating Scale (NRS) ranging from 0 to 10 (0, no pain; 10, maximum pain), which is based on a patient's self-report, is the gold standard for pain evaluation in patients who can communicate their pain intensity. On the other hand, it is very difficult to evaluate the degree of pain in critically ill patients owing to decreased consciousness level, delirium, and the effect of sedation for mechanical ventilation management...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28060054/patient-reported-and-objectively-measured-function-before-and-after-reverse-shoulder-arthroplasty
#8
Wendy J Hurd, Melissa M Morrow, Emily J Miller, Robert A Adams, John W Sperling, Kenton R Kaufman
BACKGROUND AND PURPOSE: Documenting functional outcomes after reverse shoulder arthroplasty (RSA) is critical to advancing patient care. The interplay been self-reported and objectively measured outcome measures has not been widely described. The utilization of wearable devices to document upper extremity limb activity is a new approach for objectively measuring outcomes. Therefore, the purpose of this study was to evaluate changes in pain, and self-reported function and objectively measured limb activity after RSA...
January 5, 2017: Journal of Geriatric Physical Therapy
https://www.readbyqxmd.com/read/28060003/clinical-characteristics-of-mixed-arteriovenous-leg-ulcers-a-descriptive-study
#9
Joseph A Marin, Kevin Y Woo
PURPOSE: The purpose of this study was to identify the clinical characteristics of mixed arteriovenous leg ulcers (MLU) that differentiated them from venous leg ulcers (VLU). DESIGN: Secondary analysis of data from larger electronic database. SUBJECTS AND SETTING: The sample comprised 1007 persons with lower extremity ulcers. Two hundred sixty three individuals with MLU were compared to 744 individuals with VLU; their ankle brachial indices were 0...
January 2017: Journal of Wound, Ostomy, and Continence Nursing
https://www.readbyqxmd.com/read/28053241/comparative-biology-of-pain-what-invertebrates-can-tell-us-about-how-nociception-works
#10
Brian D Burrell
The inability to adequately treat chronic pain is a worldwide health care crisis. Pain has both an emotional and a sensory component and this latter component, nociception, refers specifically to the detection of damaging or potentially damaging stimuli. Nociception represents a critical interaction between an animal and its environment and exhibits considerable evolutionary conservation across species. Using comparative approaches to understand the basic biology of nociception could promote the development of novel therapeutic strategies to treat pain and studies of nociception in invertebrates can provide especially useful insights towards this goal...
January 4, 2017: Journal of Neurophysiology
https://www.readbyqxmd.com/read/28046786/su-f-t-133-uniform-scanning-proton-therapy-for-lung-cancer-toxicity-and-its-correlation-with-dosimetry
#11
Y Zheng, S Rana, G Larson
PURPOSE: To analyze the toxicity of uniform scanning proton therapy for lung cancer patients and its correlation with dose distribution. METHODS: In this study, we analyzed the toxicity of 128 lung cancer patients, including 18 small cell lung cancer and 110 non small cell lung cancer patients. Each patient was treated with uniform scanning proton beams at our center using typically 2-4 fields. The prescription was typically 74 Cobalt gray equivalent (CGE) at 2 CGE per fraction...
June 2016: Medical Physics
https://www.readbyqxmd.com/read/28034967/a-randomized-controlled-trial-of-the-effects-of-online-pain-management-education-on-primary-care-providers
#12
Kimberlee J Trudeau, Cristina Hildebrand, Priyanka Garg, Emil Chiauzzi, Kevin L Zacharoff
OBJECTIVE:  To improve pain management practices, we developed an online interactive continuing education (CE) program for primary care providers (PCPs). This program follows the flow of clinical decision-making through simulated cases at critical pain treatment points along the pain treatment continuum. DESIGN:  A randomized controlled trial was conducted to test the efficacy of this program. Participants were randomized to either the experimental condition or the control condition (online, text-based CE program)...
December 29, 2016: Pain Medicine: the Official Journal of the American Academy of Pain Medicine
https://www.readbyqxmd.com/read/28012043/prospective-evaluation-of-health-related-quality-of-life-after-radical-cystectomy-focus-on-peri-and-postoperative-complications
#13
Alexander Kretschmer, Tobias Grimm, Alexander Buchner, Markus Grabbert, Friedrich Jokisch, Birte-Swantje Schneevoigt, Maria Apfelbeck, Gerald Schulz, Christian G Stief, Alexander Karl
OBJECTIVES: To analyse the impact of perioperative complications and complex treatment courses on postoperative health-related quality of life (HRQOL) after radical cystectomy (RC) and continent (ONB) or incontinent (IC) urinary diversion at multiple prospective time points. METHODS: A total of 121 consecutive patients underwent RC with curative intent between 2013 and 2014. HRQOL was prospectively assessed preoperatively, after 3 and 12 months, using the QLQ-C30 questionnaire...
December 23, 2016: World Journal of Urology
https://www.readbyqxmd.com/read/28003680/pseudoaneurysm-of-the-perforating-branch-of-the-deep-femoral-artery-following-anterior-cruciate-ligament-reconstruction
#14
Masataka Fujii, Takayuki Furumatsu, Yasutaka Kadota, Yoshinobu Shimamura, Shigeyuki Tsuchimochi, Toshifumi Ozaki
The present report describes the first known, case of a pseudoaneurysm of the perforating branch of the deep femoral artery following anterior cruciate ligament (ACL) reconstruction. A 19-year-old man underwent ACL reconstruction using the outside-in femoral tunnel-creation method. Seven days after the surgery, he complained of abnormal thigh pain and had swelling with local heat on the distal lateral thigh. Magnetic resonance imaging, computed tomography, and color Doppler ultrasonography showed the pseudoaneurysm in the thigh...
December 2016: Acta Medica Okayama
https://www.readbyqxmd.com/read/28003300/protocol-for-developing-disseminating-and-implementing-a-core-outcome-set-for-endometriosis
#15
Martin Hirsch, James M N Duffy, Claire Barker, Lone Hummelshoj, Neil P Johnson, Ben Mol, Khalid S Khan, Cindy Farquhar
INTRODUCTION: Endometriosis is a common gynaecological disease characterised by pain and subfertility. Randomised controlled trials evaluating treatments for endometriosis have reported many different outcomes and outcome measures. This variation restricts effective data synthesis limiting the usefulness of research to inform clinical practice. To address these methodological concerns, we aim to develop, disseminate and implement a core outcome set for endometriosis engaging with key stakeholders, including healthcare professionals, researchers and women with endometriosis...
December 21, 2016: BMJ Open
https://www.readbyqxmd.com/read/27999228/barriers-to-the-development-of-pediatric-palliative-care-in-italy
#16
Franca Benini, Marcello Orzalesi, Anna de Santi, Sabrina Congedi, Pierina Lazzarin, Federico Pellegatta, Lucia De Zen, Marco Spizzichino, Enrico Alleva
INTRODUCTION: In recent years the emergence of new types of patient, clinical situations, technological frontiers and "health" objectives have changed considerably the needs of ill children, this also concerns pediatric palliative care (PPC). In Italy, despite the introduction of legislation (Law 38/2010) stipulating the right of children and families to access appropriate services for pain control and pediatric palliative care, the availability of these services is still limited. AIM: The aim of this study is to highlight, through a review of the existing data and published literature, the critical issues that obstacle the planning and development of PPC services in Italy...
October 2016: Annali Dell'Istituto Superiore di Sanità
https://www.readbyqxmd.com/read/27994841/do-all-critical-aortic-stenosis-with-chest-pain-need-aortic-valve-replacement-a-case-report
#17
Munish Sharma, Daniel A N Mascarenhas
Aortic valve replacement (AVR) remains the cornerstone of treatment for symptomatic critical aortic stenosis (AS). It is a Class I indication that symptomatic patients with critical AS undergo either surgical or transcatheter aortic valve replacement (TAVR). We present a patient with critical AS and new angina that was managed successfully with percutaneous coronary intervention (PCI) of the Right coronary artery. Physicians should consider that not all patients with critical AS and angina necessarily require AVR...
October 24, 2016: Clinics and Practice
https://www.readbyqxmd.com/read/27984410/revisiting-escharotomy-in-patients-with-burns-in-extremities
#18
Mário Eduardo Barros, Pedro Soler Coltro, Cristina Marly Hetem, Kelvin Henrique Vilalva, Jayme Adriano Farina
Escharotomy incisions must be made in the inelastic skin eschar that is typical of circumferential third-degree burns. Later, the necrotic tissue must be debrided and substituted with a skin graft. Many reports on this topic have revealed that concepts and techniques vary widely. This study aims to present a critical review of the literature about escharotomy in burns and to highlight a different strategy to perform escharotomy in patients with burned extremities. We conducted a critical review in Pubmed/MEDLINE using the keywords "escharotomy" and "burns...
December 2, 2016: Journal of Burn Care & Research: Official Publication of the American Burn Association
https://www.readbyqxmd.com/read/27982486/the-effect-of-laughter-therapy-on-the-quality-of-life-of-nursing-home-residents
#19
Nilgün Kuru, Gülümser Kublay
AIMS AND OBJECTIVES: To carry out laughter therapy and evaluate its effect on the quality of life of nursing home residents. BACKGROUND: By improving the quality of life of residents living in nursing homes and allowing them to have a healthier existence, their lives can be extended. Therefore, interventions impacting the quality of life of older adults are of critical importance. DESIGN: Quasi-experimental design. METHOD: The study was conducted between March 2 and May 25, 2015...
December 16, 2016: Journal of Clinical Nursing
https://www.readbyqxmd.com/read/27977013/acupuncture-in-the-neonatal-intensive-care-unit-using-ancient-medicine-to-help-today-s-babies-a-review
#20
K L Chen, I Quah-Smith, G M Schmölzer, R Niemtzow, J L Oei
Acupuncture has been used for thousands of years in Eastern medicine for a variety of conditions and illnesses, including pain. Neonatal intensive care, on the other hand, is a relatively new branch of medicine that has emerged as the pivotal influence in increasing survival of critically ill newborn infants only within the last 50 years. Unfortunately, pain is an inevitable part of treatment in a neonatal intensive care unit (NICU). The control and prevention of pain remains a major issue for clinicians despite recognition and understanding of the myriad of short- and long-term problems that are associated with both pain and its treatment within the NICU environment...
December 15, 2016: Journal of Perinatology: Official Journal of the California Perinatal Association
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