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https://www.readbyqxmd.com/read/29773575/measuring-physical-activity-with-implanted-cardiac-devices-a-systematic-review
#1
Lindsey Rosman, Rachel Lampert, Samuel F Sears, Matthew M Burg
BACKGROUND: Physical activity is predictive of cardiovascular outcomes in patients with cardiovascular implantable electronic devices, yet it is not regularly assessed in routine care. Current-generation cardiovascular implantable electronic devices, however, continuously monitor patient activity through a built-in accelerometer, which provides new opportunities to remotely assess patient activity, detect changes in clinical status, and incorporate these data in risk stratification models...
May 17, 2018: Journal of the American Heart Association
https://www.readbyqxmd.com/read/29748659/bioelectrical-impedance-analysis-derived-phase-angle-at-admission-as-a-predictor-of-90-day-mortality-in-intensive-care-patients
#2
Sandra N Stapel, Wilhelmus G P M Looijaard, Ingeborg M Dekker, Armand R J Girbes, Peter J M Weijs, Heleen M Oudemans-van Straaten
BACKGROUND/OBJECTIVES: A low bioelectrical impedance analysis (BIA)-derived phase angle (PA) predicts morbidity and mortality in different patient groups. An association between PA and long-term mortality in ICU patients has not been demonstrated before. The purpose of the present study was to determine whether PA on ICU admission independently predicts 90-day mortality. SUBJECTS/ METHODS: This prospective observational study was performed in a mixed university ICU...
May 11, 2018: European Journal of Clinical Nutrition
https://www.readbyqxmd.com/read/29699493/effects-of-age-comorbidity-and-adherence-to-current-antimicrobial-guidelines-on-mortality-in-hospitalized-elderly-patients-with-community-acquired-pneumonia
#3
Xiudi Han, Fei Zhou, Hui Li, Xiqian Xing, Liang Chen, Yimin Wang, Chunxiao Zhang, Xuedong Liu, Lijun Suo, Jinxiang Wang, Guohua Yu, Guangqiang Wang, Xuexin Yao, Hongxia Yu, Lei Wang, Meng Liu, Chunxue Xue, Bo Liu, Xiaoli Zhu, Yanli Li, Ying Xiao, Xiaojing Cui, Lijuan Li, Jay E Purdy, Bin Cao
BACKGROUND: Limited information exists on the clinical characteristics predictive of mortality in patients aged ≥65 years in many countries. The impact of adherence to current antimicrobial guidelines on the mortality of hospitalized elderly patients with community-acquired pneumonia (CAP) has never been assessed. METHODS: A total of 3131 patients aged ≥65 years were enrolled from a multi-center, retrospective, observational study initiated by the CAP-China network...
April 24, 2018: BMC Infectious Diseases
https://www.readbyqxmd.com/read/29454163/exacerbations-in-adults-with-asthma-a-systematic-review-and-external-validation-of-prediction-models
#4
Rik J B Loymans, Thomas P A Debray, Persijn J Honkoop, Evelien H Termeer, Jiska B Snoeck-Stroband, Tjard R J Schermer, Willem J J Assendelft, Merel Timp, Kian Fan Chung, Ana R Sousa, Jacob K Sont, Peter J Sterk, Helen K Reddel, Gerben Ter Riet
BACKGROUND: Several prediction models assessing future risk of exacerbations in adult patients with asthma have been published. Applicability of these models is uncertain because their predictive performance has often not been assessed beyond the population in which they were derived. OBJECTIVE: This study aimed to identify and critically appraise prediction models for asthma exacerbations and validate them in 2 clinically distinct populations. METHODS: PubMed and EMBASE were searched to April 2017 for reports describing adult asthma populations in which multivariable models were constructed to predict exacerbations during any time frame...
February 15, 2018: Journal of Allergy and Clinical Immunology in Practice
https://www.readbyqxmd.com/read/29429201/-survey-on-the-prevalence-of-continuous-blood-purification-in-chinese-pediatric-critical-care
#5
X Yang, S Y Qian, Y M Zhu, X Xu, C F Liu, F Xu, X X Ren, Y Wang, Y C Zhang, G P Lu
Objective: To investigate the current application status of continuous blood purification (CBP) technology and equipment in pediatric intensive care unit (PICU) in China. Methods: A cross-sectional survey was conducted to understand the current popularization of CBP technology and equipment, the management of CBP equipment and consumables, and the application of CBP in different diseases. A questionnaire named Application Status of Continuous Blood Purification Technology was applied. Children's hospitals and polyclinic hospitals with the pediatric qualification (pediatric emergency or critical care unit members of Chinese Medical Association and Chinese Medical Doctor Association) were selected...
February 2, 2018: Zhonghua Er Ke za Zhi. Chinese Journal of Pediatrics
https://www.readbyqxmd.com/read/29426814/exploring-the-specific-needs-of-persons-with-multiple-sclerosis-for-mhealth-solutions-for-physical-activity-mixed-methods-study
#6
Guido Giunti, Jan Kool, Octavio Rivera Romero, Enrique Dorronzoro Zubiete
BACKGROUND: Multiple sclerosis (MS) is one of the world's most common neurologic disorders, with symptoms such as fatigue, cognitive problems, and issues with mobility. Evidence suggests that physical activity (PA) helps people with MS reduce fatigue and improve quality of life. The use of mobile technologies for health has grown in recent years with little involvement from relevant stakeholders. User-centered design (UCD) is a design philosophy with the goal of creating solutions specific to the needs and tasks of the intended users...
February 9, 2018: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/29402370/-impact-of-permissive-underfeeding-versus-standard-enteral-feeding-on-outcomes-in-critical-patients-requiring-mechanical-ventilation-a-prospective-randomized-controlled-study
#7
Nianbin Ma, Mingfu Shen, Zhen Wan, Sijun Pan, Xian Liu, Zhongxiang Yao
OBJECTIVE: To compare the impact of permissive underfeeding versus standard enteral feeding on outcomes in critical patients requiring mechanical ventilation (MV). METHODS: A prospective randomized controlled study was conducted. Eighty-two patients requiring MV admitted to intensive care unit (ICU) of Anji People's Hospital from January 2015 to March 2017 were enrolled, and they were randomly divided into the permissive underfeeding group (n = 40, non-protein heat was 52...
February 2018: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/29353120/phase-angle-assessment-in-critically-ill-cancer-patients-relationship-with-the-nutritional-status-prognostic-factors-and-death
#8
Tatiana Cathoud do Amaral Paes, Kátia Cansanção Correa de Oliveira, Patrícia de Carvalho Padilha, Wilza Arantes Ferreira Peres
PURPOSE: To evaluate the relationship between phase angle (PA) and nutritional status and the prognostic significance of PA in critically ill cancer patients. METHODS: 31 patients that had been admitted to the intensive care unit (ICU) of a center on oncology were evaluated. Their PA was obtained from their bioelectrical impedance within 48 h of the ICU admission. The logistic regression analysis of Cox was used in order to identify the independent predictors of the outcomes...
April 2018: Journal of Critical Care
https://www.readbyqxmd.com/read/29283966/undertriage-in-trauma-does-an-organized-trauma-network-capture-the-major-trauma-victim-a-statewide-analysis
#9
Michael A Horst, Shreya Jammula, Brian W Gross, Alan D Cook, Eric H Bradburn, Juliet Altenburg, Danielle Von Nieda, Madison Morgan, Frederick B Rogers
BACKGROUND: Proper triage of critically injured trauma patients to accredited trauma centers (TCs) is essential for survival and patient outcomes. We sought to determine the percentage of patients meeting trauma criteria who received care at non-TCs (NTCs) within the statewide trauma system that exists in the state of Pennsylvania. We hypothesized that a substantial proportion of the trauma population would be undertriaged to NTCs with undertriage rates (UTR) decreasing with increasing severity of injury...
March 2018: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/29189649/physician-assistant-student-training-for-the-inpatient-setting-a-needs-assessment
#10
Poonam Sharma, Megan Brooks, Pahresah Roomiany, Lalit Verma, Lisa Criscione-Schreiber
PURPOSE: The number of physician assistants (PAs) practicing hospital medicine is rapidly expanding. Little research has been done to determine which inpatient medicine rotation experiences are most helpful to prepare PA students for a career in inpatient medicine. We aimed to determine those skills that practicing hospitalists believe are most critical for PA students to master and to describe hospitalists' current understanding of PA training. We also sought to evaluate the current performance of our own inpatient medicine rotation for PA students...
December 2017: Journal of Physician Assistant Education
https://www.readbyqxmd.com/read/29162291/the-efficacy-of-self-disinfecting-bedrail-covers-in-an-intensive-care-unit
#11
Lisa M Esolen, Lokendra Thakur, Abraham J Layon, Thomas A Fuller, Deni-Jo Harrington, Kunal Jha, Subhashinie Kariyawasam
BACKGROUND: Hospital surfaces are considered important vectors in the spread of nosocomial pathogens. This study evaluated microbial counts on novel antimicrobial bedrail covers over a 2-week period in a critical care environment. METHODS: Disposable bedrail covers (Aionx Inc, Hershey, PA) made of a copper and silver polymer and capable of conducting an imperceptible surface potential, were installed in a case-control manner on a series of occupied intensive care unit beds...
November 19, 2017: American Journal of Infection Control
https://www.readbyqxmd.com/read/29112080/%C3%AE-lactam-therapeutic-drug-management-in-the-picu
#12
Jeffrey J Cies, Wayne S Moore, Adela Enache, Arun Chopra
OBJECTIVES: To determine whether contemporary β-lactam anti-infective dosing recommendations in critically ill children achieve concentrations associated with maximal anti-infective activity. The secondary objective was to describe the microbiological and clinical outcomes associated with β-lactam therapeutic drug management. DESIGN: Electronic Medical Record Review. SETTING: A 189-bed, freestanding children's tertiary care teaching hospital in Philadelphia, PA...
February 2018: Critical Care Medicine
https://www.readbyqxmd.com/read/29097859/quantifying-burnout-among-emergency-medicine-professionals
#13
William Wilson, Jeffrey Pradeep Raj, Girish Narayan, Murtuza Ghiya, Shakuntala Murty, Bobby Joseph
Background: Burnout is a syndrome explained as serious emotional depletion with poor adaptation at work due to prolonged occupational stress. It has three principal components namely emotional exhaustion(EE), depersonalization(DP) and diminished feelings of personal accomplishment(PA). Thus, we aimed at measuring the degree of burnout in doctors and nurses working in emergency medicine department (EMD) of 4 select tertiary care teaching hospitals in South India. Methods: A cross sectional survey was conducted among EMD professionals using a 30-item standardized pilot tested questionnaire as well as the Maslach burnout inventory...
October 2017: Journal of Emergencies, Trauma, and Shock
https://www.readbyqxmd.com/read/28961627/physician-assistant-contributions-to-medical-and-higher-education
#14
P Eugene Jones, John C Houchins
Physician assistant (PA) programs were often early adopters or initiators of innovative models of teaching, learning, and assessment. Examples of these influences include interprofessional education, competency-based education, objective-structured clinical examinations, problem-based learning, evidence-based medicine, team-based learning, and the multiple mini-interviews. In addition, the contributions and presence of PAs in the academic health center teaching environment have also fostered appreciation from other health professionals for the skill level and capacity of PAs on the care team...
October 2017: Journal of Physician Assistant Education
https://www.readbyqxmd.com/read/28932559/pupillary-abnormalities-in-non-selected-critically-ill-patients-an-observational-study
#15
Philippe Portran, Martin Cour, Romain Hernu, Sylvie de la Salle, Laurent Argaud
BACKGROUND: Repeated pupillary examination is a key element of neurologic surveillance in intensive care units (ICU). However, in non-selected critically ill patients, the clinical interest of monitoring pupillary diameter and light reflex is poorly documented. We aimed to determine the prevalence and the etiologies of pupillary abnormalities (PAs) in this ICU patient population. METHODS: We performed a prospective, observational study in a medical university affiliated ICU over a 6-month period...
August 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28922265/-stuck-in-the-icu-caring-for-children-with-chronic-critical-illness
#16
Carrie M Henderson, Erin P Williams, Miriam C Shapiro, Emily Hahn, Laura Wright-Sexton, Nancy Hutton, Renee D Boss
OBJECTIVE: Neonatal ICUs and PICUs increasingly admit patients with chronic critical illness: children whose medical complexity leads to recurrent and prolonged ICU hospitalizations. We interviewed participants who routinely care for children with chronic critical illness to describe their experiences with ICU care for pediatric chronic critical illness. DESIGN: Semi-structured interviews. Interviews were transcribed and analyzed for themes. SETTING: Stakeholders came from five regions (Seattle, WA; Houston, TX; Jackson, MS; Baltimore, MD; and Philadelphia, PA)...
November 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28871326/mortality-and-morbidity-after-hartmann-s-procedure-versus-primary-anastomosis-without-a-diverting-stoma-for-colorectal-perforation-a-nationwide-observational-study
#17
Asuka Tsuchiya, Hideo Yasunaga, Yusuke Tsutsumi, Hiroki Matsui, Kiyohide Fushimi
BACKGROUND: The benefit of primary anastomosis (PA) without a diverting stoma over Hartmann's procedure (HP) for colorectal perforation remains controversial. We compared postoperative mortality and morbidity between HP and PA without a diverting stoma for colorectal perforation of various etiologies. METHODS: Using the Japanese Diagnosis Procedure Combination database, we extracted data on patients who underwent emergency open laparotomy for colorectal perforation of various etiologies from July 1, 2010 to March 31, 2014...
March 2018: World Journal of Surgery
https://www.readbyqxmd.com/read/28856066/estimation-of-time-period-for-effective-human-inhalational-anthrax-treatment-including-antitoxin-therapy
#18
Lewis Rubinson, Alfred Corey, Dan Hanfling
INTRODUCTION: Infrequent natural human inhalational anthrax cases coupled with high bioterrorism risk have brought about use of animal models to serve as the basis for approval of novel treatments. For inhalational anthrax, protective antigen (PA) drives much of the mortality, and raxibacumab, an anti-PA monoclonal antibody, has been approved for therapeutic use using the Animal Rule. Given the paucity of human inhalational anthrax clinical data including PA kinetics, the post-exposure period for effective treatment of human disease remains unknown...
July 28, 2017: PLoS Currents
https://www.readbyqxmd.com/read/28803496/management-of-multidrug-resistant-pseudomonas-aeruginosa-in-the-intensive-care-unit-state-of-the-art
#19
Alberto Enrico Maraolo, Marco Cascella, Silvia Corcione, Arturo Cuomo, Salvatore Nappa, Guglielmo Borgia, Francesco Giuseppe De Rosa, Ivan Gentile
Pseudomonas aeruginosa (PA) is one of the most important causes of healthcare-related infections among Gram-negative bacteria. The best therapeutic approach is controversial, especially for multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains as well as in the setting of most severe patients, such as in the intensive care unit (ICU). Areas covered: This article addresses several points. First, the main microbiological aspects of PA, focusing on its wide array of resistance mechanisms. Second, risk factors and the worse outcome linked to MDR-PA infection...
September 2017: Expert Review of Anti-infective Therapy
https://www.readbyqxmd.com/read/28793822/dose-response-head-to-head-comparison-of-inodilators-dobutamine-milrinone-and-levosimendan-in-chronic-experimental-pulmonary-hypertension
#20
Marta Tavares-Silva, Mohamed Alaa, Sara Leite, José Oliveira-Pinto, Lucas Lopes, Adelino F Leite-Moreira, André P Lourenço
The choice of inodilator drug in the acute management of patients with pulmonary hypertension (PH) having right ventricular (RV) failure remains unsettled and challenging. Comprehensive experimental evaluations may provide further insight and fundamental translational research clues to support inodilator selection and clinical trial design. Our aim was to compare acute dose-response hemodynamic effects of inodilators dobutamine (DOB), milrinone (MIL), and levosimendan (LEV) in chronic experimental PH. Seven-week-old male Wistar rats were randomly injected with 60 mg·kg-1 monocrotaline (MCT) or vehicle (Ctrl, n = 7) and underwent systemic and pulmonary artery (PA) pressure and RV pressure-volume (PV) hemodynamic evaluation under halogenate anesthesia 24 to 30 days after injection...
September 2017: Journal of Cardiovascular Pharmacology and Therapeutics
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