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https://www.readbyqxmd.com/read/29781504/epidural-versus-non-epidural-or-no-analgesia-for-pain-management-in-labour
#1
REVIEW
Millicent Anim-Somuah, Rebecca Md Smyth, Allan M Cyna, Anna Cuthbert
BACKGROUND: Epidural analgesia is a central nerve block technique achieved by injection of a local anaesthetic close to the nerves that transmit pain, and is widely used as a form of pain relief in labour. However, there are concerns about unintended adverse effects on the mother and infant. This is an update of an existing Cochrane Review (Epidural versus non-epidural or no analgesia in labour), last published in 2011. OBJECTIVES: To assess the effectiveness and safety of all types of epidural analgesia, including combined-spinal-epidural (CSE) on the mother and the baby, when compared with non-epidural or no pain relief during labour...
May 21, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29780032/severe-outcomes-associated-with-respiratory-viruses-in-newborns-and-infants-a-prospective-viral-surveillance-study-in-jordan
#2
Najwa Khuri-Bulos, Lindsey Lawrence, Bhinnata Piya, Li Wang, Christopher Fonnesbeck, Samir Faouri, Asem Shehabi, Sten H Vermund, John V Williams, Natasha B Halasa
OBJECTIVE: To assess virus-specific hospitalisation rates, risk factors for illness severity and seasonal trends in children hospitalised with acute respiratory infections (ARI). DESIGN: Prospective cohort study. SETTING: A government hospital serving low-income and middle-income population in Amman, Jordan. PARTICIPANTS: Children under 2 years of age hospitalised with fever and/or respiratory symptoms (n=3168) from 16 March 2010 to 31 March 2013...
May 20, 2018: BMJ Open
https://www.readbyqxmd.com/read/29768662/immersion-in-water-during-labour-and-birth
#3
REVIEW
Elizabeth R Cluett, Ethel Burns, Anna Cuthbert
BACKGROUND: Water immersion during labour and birth is increasingly popular and is becoming widely accepted across many countries, and particularly in midwifery-led care settings. However, there are concerns around neonatal water inhalation, increased requirement for admission to neonatal intensive care unit (NICU), maternal and/or neonatal infection, and obstetric anal sphincter injuries (OASIS). This is an update of a review last published in 2011. OBJECTIVES: To assess the effects of water immersion during labour and/or birth (first, second and third stage of labour) on women and their infants...
May 16, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29760928/aneurysmal-subarachnoid-hemorrhage-intensive-care-for-improving-neurological-outcome
#4
REVIEW
Tomoya Okazaki, Yasuhiro Kuroda
Background: Aneurysmal subarachnoid hemorrhage is a life-threatening disease requiring neurocritical care. Delayed cerebral ischemia is a well-known complication that contributes to unfavorable neurological outcomes. Cerebral vasospasm has been thought to be the main cause of delayed cerebral ischemia, and although several studies were able to decrease cerebral vasospasm, none showed improved neurological outcomes. Our target is not cerebral vasospasm but improving neurological outcomes...
2018: Journal of Intensive Care
https://www.readbyqxmd.com/read/29753653/cardiopulmonary-bypass-in-non-cardiac-surgery
#5
Timothy Luke Surman, Michael George Worthington, Jose Martinelli Nadal
BACKGROUND: Cardiopulmonary bypass (CPB) and extracorporeal membrane oxygenation (ECMO) are used to facilitate circulatory support in standard cardiac surgery and emergency intervention, but CPB and ECMO are not used routinely in non-cardiac surgery involving the thorax and major vessels. The primary aim of this study was to identify the type of non-cardiac procedures and bypass used in our institution and review the patient outcomes including perioperative and bypass complications. METHODS: A retrospective study was performed within the Royal Adelaide Hospital Cardiothoracic Surgery Unit (CTSU) that examined all operations between 2006 and 2014...
April 19, 2018: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/29746377/risk-factors-for-severe-community-acquired-pneumonia-among-children-hospitalized-with-cap-younger-than-5-years-of-age
#6
Wei Shan, Ting Shi, Kaile Chen, Jian Xue, Yin Wang, Jia Yu, Genming Zhao, Jianmei Tian, Tao Zhang
BACKGROUND: CAP causes great morbidity and mortality as well as enormous economic burden worldwide. This study intended to describe the clinical characteristics of CAP and explore the risk factors of severe CAP among children in downtown Suzhou, China. METHODS: This was a retrospective study of childhood hospitalizations in Soochow University Affiliated Children's Hospital (SCH) from January 1, 2010 to December 31, 2014. Children who were residents of downtown Suzhou, 29 days to <5 years of age, with discharge diagnosis codes (ICD-10) J09 to J18 and J20 to J22 were included...
May 9, 2018: Pediatric Infectious Disease Journal
https://www.readbyqxmd.com/read/29743762/thromboelastographic-analysis-of-hemostatic-abnormalities-in-dengue-patients-admitted-in-a-multidisciplinary-intensive-care-unit-a-cross-sectional-study
#7
V K Sureshkumar, Deepak Vijayan, Shamim Kunhu, Zuhail Mohamed, Sujith Thomas, Muraleedharan Raman
Background: Dengue fever is an important tropical infection causing significant mortality. The pathophysiology of hematological abnormalities in dengue remains poorly studied. In this study, we analyzed the hematological abnormalities by thromboelastography (TEG). Methods: This cross-sectional study evaluated complicated dengue patients with TEG. Thromboelastographic variables were categorized into six patterns: factor deficiency, platelet dysfunction, enzymatic hypercoagulability, combined enzymatic and platelet hypercoagulability, primary fibrinolysis, and secondary hyperfibrinolysis...
April 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29735504/pneumonitis-a-serious-adverse-effect-of-pd-l1-inhibitors-including-pembrolizumab
#8
Frances Rickard, Catherine Hyams, Andrew T Low
A 70-year-old man presented with breathlessness, cough and fever while receiving pembrolizumab for melanoma. A CT pulmonary angiogram demonstrated small bilateral upper lobe segmental pulmonary emboli with patchy ground-glass opacities and basal perilobular consolidation, in keeping with organising pneumonia. He was treated for community-acquired pneumonia and pulmonary emboli but rapidly deteriorated, with increasing hypoxia and dyspnoea. He was admitted to the intensive care unit for support with continuous positive airway pressure and high flow nasal oxygen...
May 7, 2018: BMJ Case Reports
https://www.readbyqxmd.com/read/29724249/crimean-congo-hemorrhagic-fever-with-hepatic-impairment-and-vaginal-hemorrhage-a-case-report
#9
Ermira Muco, Najada Como, Siva Bino, Arjan Harxhi, Pellumb Pipero, Majlinda Kota, Jonida Mehmeti, Arta Kushi, Dhimiter Kraja
BACKGROUND: Crimean-Congo hemorrhagic fever is a tick-borne disease described in more than 30 countries in Europe, Asia, and Africa. Albania is located in the southwestern part of the Balkan Peninsula. In 1986, the first case of Crimean-Congo hemorrhagic fever was registered, and cases of patients with hemorrhagic fever are rising, and most of them present in a serious condition, when the mortality rate is very high. In districts like Mirdite, Lezhe, Gjirokaster, Skrapar, Erseke, and Kukes, there is delineated human-to-human transmission...
May 4, 2018: Journal of Medical Case Reports
https://www.readbyqxmd.com/read/29719745/acute-acalculous-cholecystitis-in-the-setting-of-negative-ultrasound-and-computed-tomography-scan-of-the-abdomen
#10
Muhammad Shafiq, Yousaf Zafar
Acute acalculous cholecystitis (AAC) is most commonly seen after surgery in critically ill patients. Early diagnosis and treatment is the key in the management of AAC. Ultrasound is the commonly used first modality for right upper quadrant (RUQ) pain with sensitivity equal to or greater than 80% for AAC. Computed tomography (CT) scan is reported to have a sensitivity close to 90% and if both the ultrasound and CT scan are combined, it further increases the sensitivity for the diagnosis of AAC. It is unlikely for AAC to be present in the setting of both negative ultrasound and CT scan of the abdomen...
February 28, 2018: Curēus
https://www.readbyqxmd.com/read/29709990/human-parechovirus-infection-in-children-in-taiwan-a-retrospective-single-hospital-study
#11
Jenn-Tzong Chang, Yao-Shen Chen, Bao-Chen Chen, Tsi-Shu Huang, Tsung-Hsien Chang
To understand human parechovirus (HPeV) infections in Taiwanese children, we analyzed data for 112 children (age ≤ 10 years) with HPeV infection diagnosed from July 2007 to June 2016 in a medical centre in Kaohsiung, southern Taiwan. Infection was with HPeV1 (n=94), HPeV3 (n=3), HPeV4 (n=3), HPeV6 (n=1) and non-typeable HPeV (n=11). We compared the clinical implication for children younger than 3 months (n=56) and 3 months and older (n=31), excluding the 25 children with concomitant infection. Fever was noted in almost half of the children younger than 3 months but was more frequent in older than younger children (83...
April 27, 2018: Japanese Journal of Infectious Diseases
https://www.readbyqxmd.com/read/29705974/extreme-hypercalcemia-in-a-kidney-transplant-recipient
#12
Erol Demir, Cagla Karaoglan, Gulcin Yegen, Betul Sair, Halil Yazici, Aydin Turkmen, Mehmet Sukru Sever
Post-transplant hypercalcemia is a major problem in renal transplant recipients, which may negatively affect both graft and patient survival. In this paper, we present a 66-year-old male kidney transplant recipient, who was admitted to our clinic with symptoms of fever, nausea, vomiting and lethargy. Laboratory data showed good renal function; however, a serum calcium level of 22.1 mg/dL. The patient was treated by isotonic saline together with furosemide and methylprednisolone. Because of treatment resistance, subcutaneous calcitonin and ibandronate were added to the treatment protocol as well...
April 28, 2018: CEN Case Reports
https://www.readbyqxmd.com/read/29690727/-clinical-experience-and-next-generation-sequencing-analysis-of-encephalitis-caused-by-pseudorabies-virus
#13
W L Zhao, Y H Wu, H F Li, S Y Li, S Y Fan, H L Wu, Y J Li, Y L Lü, J Han, W C Zhang, Y Zhao, G L Li, X D Qiao, H T Ren, Y C Zhu, B Peng, L Y Cui, H Z Guan
Objective: To detect potential pathogens including pseudorabies virus in patients with encephalitis of unknown etiology in China and describe novel encephalitic entities. Methods: Patients with clinically suspected infectious encephalitis were enrolled in a multicenter study to identify the pathogens in PUMCH Encephalitis Program.Next-generation sequencing(NGS) of cerebrospinal fluid (CSF) was used in patients with encephalitis of unknown etiology enrolled from 2016 to 2017.The patients diagnosed as PRV encephalitis were studied to describe this novel entity...
April 17, 2018: Zhonghua Yi Xue za Zhi [Chinese medical journal]
https://www.readbyqxmd.com/read/29690685/-current-status-of-diagnosis-and-treatment-of-community-acquired-pneumonia-in-shanghai-revealed-by-a-questionnaire-analysis
#14
J Liu, J Zhang, Q J Cheng, J F Xu, Z J Jie, Y Jiao, Y Huang, J M Qu
Objective: To understand the current status of diagnosis and treatment of community-acquired pneumonia (CAP) among doctors in various hospitals across Shanghai, for the purpose of promoting the 2016 clinical practice guidelines for adult CAP of China. Methods: A questionnaire was designed to address the common questions in CAP management. The responses were collected via WeChat and the data were analyzed. Results: A total of 1 254 valid questionnaires were received, 46.1% from tertiary , 26.4% from secondary and 27...
April 12, 2018: Chinese Journal of Tuberculosis and Respiratory Diseases
https://www.readbyqxmd.com/read/29665881/seeking-out-sari-an-automated-search-of-electronic-health-records
#15
John C O'Horo, Mikhail Dziadzko, Amra Sakusic, Rashid Ali, M Rizwan Sohail, Daryl J Kor, Ognjen Gajic
The definition of severe acute respiratory infection (SARI) - a respiratory illness with fever and cough, occurring within the past 10 days and requiring hospital admission - has not been evaluated for critically ill patients. Using integrated electronic health records data, we developed an automated search algorithm to identify SARI cases in a large cohort of critical care patients and evaluate patient outcomes. We conducted a retrospective cohort study of all admissions to a medical intensive care unit from August 2009 through March 2016...
April 18, 2018: Epidemiology and Infection
https://www.readbyqxmd.com/read/29657373/severe-varicella-pneumonia-in-adults-seven-years-single-center-experience-from-india
#16
Akashdeep Singh, Siddharth Parkash, Sunil K Gupta, R K Soni
Context: Varicella pneumonia is a rare but a serious complication of chickenpox in adults. There is paucity of data on varicella pneumonia from India. Aims: The aim of this study is to describe the clinical manifestations, hospital course, treatment, and outcome of adult patients with severe varicella pneumonia. Settings and Design: This was a retrospective, observational study of patients with severe varicella pneumonia attending a tertiary care teaching hospital...
March 2018: Indian Journal of Critical Care Medicine
https://www.readbyqxmd.com/read/29655864/comparison-of-the-severity-of-respiratory-disease-in-children-testing-positive-for-enterovirus-d68-and-human-rhinovirus
#17
Esra Caylan, Ezra Weinblatt, John Welter, Allen Dozor, Guiqing Wang, Sheila M Nolan
OBJECTIVE: To compare the characteristics and severity of respiratory disease in children testing positive for enterovirus D68 (EV-D68) and for human rhinovirus (RhV). STUDY DESIGN: A retrospective single center study of children presenting with acute respiratory symptoms and positive polymerase chain reaction for RhV/EV from September 1, 2014 through October 31, 2014 was performed. Specimens were subsequently tested specifically for EV-D68 and specimens identified as RhV were subtyped when possible into RhV-A, RhV-B, and RhV-C species...
April 11, 2018: Journal of Pediatrics
https://www.readbyqxmd.com/read/29650049/variation-in-general-supportive-and-preventive-intensive-care-management-of-traumatic-brain-injury-a-survey-in-66-neurotrauma-centers-participating-in-the-collaborative-european-neurotrauma-effectiveness-research-in-traumatic-brain-injury-center-tbi-study
#18
Jilske A Huijben, Victor Volovici, Maryse C Cnossen, Iain K Haitsma, Nino Stocchetti, Andrew I R Maas, David K Menon, Ari Ercole, Giuseppe Citerio, David Nelson, Suzanne Polinder, Ewout W Steyerberg, Hester F Lingsma, Mathieu van der Jagt
BACKGROUND: General supportive and preventive measures in the intensive care management of traumatic brain injury (TBI) aim to prevent or limit secondary brain injury and optimize recovery. The aim of this survey was to assess and quantify variation in perceptions on intensive care unit (ICU) management of patients with TBI in European neurotrauma centers. METHODS: We performed a survey as part of the Collaborative European NeuroTrauma Effectiveness Research in Traumatic Brain Injury (CENTER-TBI) study...
April 13, 2018: Critical Care: the Official Journal of the Critical Care Forum
https://www.readbyqxmd.com/read/29644912/amalgamation-of-systemic-inflammatory-response-syndrome-score-with-c-reactive-protein-level-in-evaluating-acute-pancreatitis-severity-in-children
#19
Wei Zheng, Linqian Zhang, Gao Long, Bo Chen, Xiaoli Shu, Mizu Jiang
BACKGROUND AND AIM: Systemic inflammatory response syndrome (SIRS) has to do with how the body reacts to injury. Herein, we analyzed the clinical features of acute pancreatitis (AP) in children with SIRS complication and investigated the role of SIRS score combined with C-reactive protein (CRP) level in assessing AP severity in children. METHODS: This retrospective cohort study involved 111 children hospitalized with AP at the Children's Hospital of Zhejiang University School of Medicine between January 2012 and August 2017...
April 12, 2018: Scandinavian Journal of Gastroenterology
https://www.readbyqxmd.com/read/29642928/diagnostic-and-management-of-life-threatening-adult-onset-still-disease-a-french-nationwide-multicenter-study-and-systematic-literature-review
#20
Antoine Néel, Anaïs Wahbi, Benoit Tessoulin, Julien Boileau, Dorothée Carpentier, Olivier Decaux, Laurence Fardet, Guillaume Geri, Pascal Godmer, Cécile Goujard, Hervé Maisonneuve, Arnaud Mari, Jacques Pouchot, Jean-Marc Ziza, Cédric Bretonnière, Mohamed Hamidou
BACKGROUND: Adult-onset Still disease (AOSD) is a rare systemic inflammatory disorder. A few patients develop organ complications that can be life-threatening. Our objectives were to describe the disease course and phenotype of life-threatening AOSD, including response to therapy and long-term outcome. METHODS: A multicenter case series of intensive care medicine (ICU) patients with life-threatening AOSD and a systematic literature review. RESULTS: Twenty patients were included...
April 11, 2018: Critical Care: the Official Journal of the Critical Care Forum
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