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pulmonary and critical care

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https://www.readbyqxmd.com/read/28449491/characteristics-and-provision-of-care-of-patients-with-the-acute-respiratory-distress-syndrome-descriptive-findings-from-the-dacapo-cohort-baseline-and-comparison-with-international-findings
#1
Frank Dodoo-Schittko, Susanne Brandstetter, Magdalena Brandl, Sebastian Blecha, Michael Quintel, Steffen Weber-Carstens, Stefan Kluge, Patrick Meybohm, Caroline Rolfes, Björn Ellger, Friedhelm Bach, Tobias Welte, Thomas Muders, Kathrin Thomann-Hackner, Thomas Bein, Christian Apfelbacher
BACKGROUND: Little is known about the characteristics and real world life circumstances of ARDS (acute respiratory distress syndrome) patient populations. This knowledge is essential for transferring evidence-based therapy into routine healthcare. The aim of this study was to report socio-demographic and clinical characteristics in an unselected population of ARDS patients and to compare these results to findings from other large ARDS cohorts. METHODS: A German based cross-sectional observational study was carried out...
March 2017: Journal of Thoracic Disease
https://www.readbyqxmd.com/read/28422779/the-utility-of-high-fidelity-simulation-for-training-critical-care-fellows-in-the-management-of-extracorporeal-membrane-oxygenation-emergencies-a-randomized-controlled-trial
#2
Bishoy M Zakhary, Lily M Kam, Brian S Kaufman, Kevin J Felner
OBJECTIVE: Although extracorporeal membrane oxygenation volume has increased, proficiency in the technology requires extensive training. We compared traditional water-drill-based extracorporeal membrane oxygenation training with simulation-based extracorporeal membrane oxygenation training with the hypothesis that simulation-based training is superior. DESIGN: Randomized controlled trial. SETTING: Academic medical center. SUBJECTS: Pulmonary/critical care fellows...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28422775/a-contemporary-assessment-of-acute-mechanical-ventilation-in-beijing-description-costs-and-outcomes
#3
Yanping Ye, Bo Zhu, Li Jiang, Qi Jiang, Meiping Wang, Lin Hua, Xiuming Xi
OBJECTIVE: To evaluate the contemporary practice, outcomes, and costs related to mechanical ventilation among ICUs in China. DESIGN: A prospective observational cohort study. SETTING: Fourteen ICUs among 13 hospitals in Beijing, China. PATIENTS: Seven hundred ninety-three patients who received at least 24 hours of mechanical ventilation within the first 48 hours of ICU stay. INTERVENTION: None...
April 18, 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28417586/icu-mortality-is-increased-with-high-admission-serum-osmolarity-in-all-patients-other-than-those-admitted-with-pulmonary-diseases-and-hypoxia
#4
Shailesh Bihari, Shivesh Prakash, Sandra L Peake, Michael Bailey, David Pilcher, Andrew Bersten
BACKGROUND AND OBJECTIVE: High serum osmolarity has been shown to be lung protective. There is lack of clinical studies evaluating the impact on outcomes such as mortality. We aimed to examine the effect of serum osmolarity on intensive care unit (ICU) mortality in critically ill patients METHODS: Data from January 2000 to December 2012 was accessed using the Australian and New Zealand Intensive Care Society (ANZICS) Clinical Outcomes and Resource Evaluation (CORE) database. A total of 509 180 patients were included...
April 17, 2017: Respirology: Official Journal of the Asian Pacific Society of Respirology
https://www.readbyqxmd.com/read/28398907/cardiopulmonary-monitoring-of-shock
#5
James Simmons, Corey E Ventetuolo
PURPOSE OF REVIEW: We will briefly review the classification of shock and the hallmark features of each subtype. Available modalities for monitoring shock patients will be discussed, along with evidence supporting the use, common pitfalls, and practical considerations of each method. RECENT FINDINGS: As older, invasive monitoring methods such as the pulmonary artery catheter have fallen out of favor, newer technologies for cardiac output estimation, echocardiography, and noninvasive tests such as passive leg raising have gained popularity...
June 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/28398076/refining-low-physical-activity-measurement-improves-frailty-assessment-in-advanced-lung-disease-and-survivors-of-critical-illness
#6
Matthew R Baldwin, Jonathan P Singer, Debbie Huang, Jessica Sell, Wendy C Gonzalez, Lauren Pollack, Mathew S Maurer, Frank F D'Ovidio, Matthew Bacchetta, Joshua R Sonett, Selim M Arcasoy, Lori Shah, Hilary Robbins, Steven R Hays, Jasleen Kukreja, John R Greenland, Rupal J Shah, Lorriana Leard, Matthew Morrell, Cynthia Gries, Patricia P Katz, Jason D Christie, Joshua M Diamond, David J Lederer
RATIONALE: The frail phenotype has gained popularity as a clinically relevant measure in adults with advanced lung disease and critical illness survivors. Since respiratory disease and chronic illness can greatly limit physical activity, the measurement of participation in traditional leisure-time activities as a frailty component may lead to substantial misclassification of frailty in pulmonary and critical care patients. OBJECTIVES: To test and validate replacing the Duke Activities Scale Index (DASI), a simple 12-item questionnaire, for the Minnesota Leisure Time Activities (MLTA), a detailed questionnaire covering 18 leisure time activities, as the measure of low activity in the Fried frailty phenotype instrument (FFP)...
April 11, 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28389120/reference-equations-for-handgrip-strength-normative-values-in-young-adult-and-middle-aged-subjects
#7
Jordão Lopes, Samantha Torres Grams, Edy Floriano da Silva, Luana Adriano de Medeiros, Christina May Moran de Brito, Wellington Pereira Yamaguti
BACKGROUND & AIMS: Handgrip strength (HS) has been widely used as a functionality parameter of the upper limbs (UL) and general health. The measurement of HS by dynamometry is a low cost, non-invasive method of simple applicability, widely used in pulmonary rehabilitation and in critical care units. However, there are no reports in the literature of reference equations for the Brazilian population involving young and middle-aged adults. The aim of this study was to establish reference equations to predict normal HS for young and middle-aged adults through demographic and anthropometric data...
March 24, 2017: Clinical Nutrition: Official Journal of the European Society of Parenteral and Enteral Nutrition
https://www.readbyqxmd.com/read/28386717/co-registration-of-pre-operative-ct-with-ex-vivo-surgically-excised-ground-glass-nodules-to-define-spatial-extent-of-invasive-adenocarcinoma-on-in-vivo-imaging-a-proof-of-concept-study
#8
Mirabela Rusu, Prabhakar Rajiah, Robert Gilkeson, Michael Yang, Christopher Donatelli, Rajat Thawani, Frank J Jacono, Philip Linden, Anant Madabhushi
OBJECTIVE: To develop an approach for radiology-pathology fusion of ex vivo histology of surgically excised pulmonary nodules with pre-operative CT, to radiologically map spatial extent of the invasive adenocarcinomatous component of the nodule. METHODS: Six subjects (age: 75 ± 11 years) with pre-operative CT and surgically excised ground-glass nodules (size: 22.5 ± 5.1 mm) with a significant invasive adenocarcinomatous component (>5 mm) were included...
April 6, 2017: European Radiology
https://www.readbyqxmd.com/read/28385031/does-paid-versus-unpaid-supplementary-caregiving-matter-in-preventable-readmissions
#9
Hsueh-Fen Chen, Taiye Oluyomi Popoola, Sumihiro Suzuki
OBJECTIVES: To examine the impact of paid and unpaid supplementary caregiving on preventable readmissions among Medicare home health beneficiaries with diabetes. STUDY DESIGN: A retrospective cohort study with a home health episode as the unit of analysis. METHODS: We gathered multiple 2009 Medicare data and national datasets (eg, Area Health Resources File). We used propensity score matching based on beneficiaries' predisposing, enabling, and health need factors to create matched cohorts for episodes solely assisted by paid supplementary caregivers versus those solely assisted by unpaid supplementary caregivers...
March 1, 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28384600/a-prospective-study-of-fungal-biomarkers-to-improve-management-of-invasive-fungal-diseases-in-a-mixed-specialty-critical-care-unit
#10
Alida Fe Talento, Katie Dunne, Eimear Ann Joyce, Michael Palmer, Elizabeth Johnson, P Lewis White, Jan Springer, Juergen Loeffler, Thomas Ryan, Daniel Collins, Thomas R Rogers
PURPOSE: The diagnosis of invasive fungal diseases (IFD) in critical care patients (CrCP) is difficult. The study investigated the performance of a set of biomarkers for diagnosis of IFD in a mixed specialty critical care unit (CrCU). METHODS: A prospective observational study in patients receiving critical care for ≥7days was performed. Serum samples were tested for the presence of: (1-3) - β-d-glucan (BDG), galactomannan (GM), and Aspergillus fumigatus DNA...
March 30, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28379812/developing-a-research-agenda-for-integrating-palliative-care-into-critical-care-and-pulmonary-practice-to-improve-patient-and-family-outcomes
#11
Rebecca A Aslakson, Lynn F Reinke, Christopher Cox, Erin K Kross, Roberto P Benzo, J Randall Curtis
BACKGROUND: Palliative care is a medical specialty and philosophy of care that focuses on reducing suffering among patients with serious illness and their family members, regardless of disease diagnosis or prognosis. As critical illness or moderate to severe pulmonary disease confers significant disease-related symptom burdens, palliative care and palliative care specialists can aid in reducing symptom burden and improving quality of life among these patients and their family members...
April 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28366285/a-review-of-hemodynamic-monitoring-techniques-methods-and-devices-for-the-emergency-physician
#12
Abdullah E Laher, Matthew J Watermeyer, Sean K Buchanan, Nicole Dippenaar, Nelly Clotilde Tchouambou Simo, Feroza Motara, Muhammed Moolla
The emergency department (ED) is frequently the doorway to the intensive care unit (ICU) for a significant number of critically ill patients presenting to the hospital. Hemodynamic monitoring (HDM) which is a key component in the effective management of the critically ill patient presenting to the ED, is primarily concerned with assessing the performance of the cardiovascular system and determining the correct therapeutic intervention to optimise end-organ oxygen delivery. The spectrum of hemodynamic monitoring ranges from simple clinical assessment and routine bedside monitoring to point of care ultrasonography and various invasive monitoring devices...
March 18, 2017: American Journal of Emergency Medicine
https://www.readbyqxmd.com/read/28363365/chest-wall-trauma
#13
REVIEW
Sarah Majercik, Fredric M Pieracci
Chest wall trauma is common, and contributes significantly to morbidity and mortality of trauma patients. Early identification of major chest wall and concomitant intrathoracic injuries is critical. Generalized management of multiple rib fractures and flail chest consists of adequate pain control (including locoregional modalities); management of pulmonary dysfunction by invasive and noninvasive means; and, in some cases, surgical fixation. Multiple studies have shown that patients with flail chest have substantial benefit (decreased ventilator and intensive care unit days, improved pulmonary function, and improved long-term functional outcome) when they undergo surgery compared with nonoperative management...
May 2017: Thoracic Surgery Clinics
https://www.readbyqxmd.com/read/28362539/whither-the-pulmonary-ward-attending-preserving-subspecialty-exposure-in-united-states-internal-medicine-residency-training
#14
Lekshmi Santhosh, Jennifer Babik, Mark R Looney, Harry Hollander
Twenty years ago, the term "hospitalist" was coined at the University of California-San Francisco (San Francisco, CA), heralding a new specialty focused on the care of inpatients. There are now more than 50,000 hospitalists practicing in the United States. At many academic medical centers, hospitalists are largely replacing subspecialists as attendings on the inpatient medicine wards. At University of California-San Francisco, this has been accompanied by declining percentages of residency graduates who enter subspecialty training in internal medicine...
April 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28362524/multicenter-validation-of-a-customizable-scoring-tool-for-selection-of-trainees-for-a-residency-or-fellowship-program-the-east-ist-study
#15
Gabriel T Bosslet, W Graham Carlos, David J Tybor, Jennifer McCallister, Candace Huebert, Ashley Henderson, Matthew C Miles, Homer Twigg, Catherine R Sears, Cynthia Brown, Mark O Farber, Tim Lahm, John D Buckley
RATIONALE: Few data have been published regarding scoring tools for selection of postgraduate medical trainee candidates that have wide applicability. OBJECTIVES: The authors present a novel scoring tool developed to assist postgraduate programs in generating an institution-specific rank list derived from selected elements of the U.S. Electronic Residency Application System (ERAS) application. METHODS: The authors developed and validated an ERAS and interview day scoring tool at five pulmonary and critical care fellowship programs: the ERAS Application Scoring Tool-Interview Scoring Tool...
April 2017: Annals of the American Thoracic Society
https://www.readbyqxmd.com/read/28357636/probable-catastrophic-antiphospholipid-syndrome-with-intracerebral-hemorrhage-secondary-to-epstein-barr-viral-infection
#16
Mark P Plummer, Adam M H Young, Ronan O'Leary, Maxwell S Damian, Andrea Lavinio
BACKGROUND: Catastrophic antiphospholipid syndrome (CAPS) is a rare, severe variant of antiphospholipid syndrome with a high mortality rate. We report a unique case of CAPS secondary to Epstein-Barr viral (EBV) infection complicated by pulmonary and intracerebral hemorrhage. A review of the CAPS literature relevant to intensive care practice is used to outline a rational approach to diagnosis and management. METHODS: All data are from a single patient admitted to the Neurosciences Critical Care Unit in Addenbrooke's Hospital, Cambridge, in March 2016...
March 29, 2017: Neurocritical Care
https://www.readbyqxmd.com/read/28355466/invasive-mould-infections-in-the-icu-setting-complexities-and-solutions
#17
Matteo Bassetti, Emilio Bouza
Infections caused by filamentous fungi represent a major burden in the ICU. Invasive aspergillosis is emerging in non-neutropenic individuals with predisposing conditions, e.g. corticosteroid treatment, chronic obstructive pulmonary disease, liver cirrhosis, solid organ cancer, HIV infection and transplantation. Diagnosis is challenging because the signs and symptoms are non-specific, and initiation of additional diagnostic examinations is often delayed because clinical suspicion is low. Isolation of an Aspergillus species from the respiratory tract in critically ill patients, and tests such as serum galactomannan, bronchoalveolar lavage 1-3-β-d-glucan and specific PCR should be interpreted with caution...
March 1, 2017: Journal of Antimicrobial Chemotherapy
https://www.readbyqxmd.com/read/28351016/nano-enabled-paper-humidity-sensor-for-mobile-based-point-of-care-lung-function-monitoring
#18
Mitradip Bhattacharjee, Harshal B Nemade, Dipankar Bandyopadhyay
The frequency of breathing and peak flow rate of exhaled air are necessary parameters to detect chronic obstructive pulmonary diseases (COPDs) such as asthma, bronchitis, or pneumonia. We developed a lung function monitoring point-of-care-testing device (LFM-POCT) consisting of mouthpiece, paper-based humidity sensor, micro-heater, and real-time monitoring unit. Fabrication of a mouthpiece of optimal length ensured that the exhaled air was focused on the humidity-sensor. The resistive relative humidity sensor was developed using a filter paper coated with nanoparticles, which could easily follow the frequency and peak flow rate of the human breathing...
March 22, 2017: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/28343949/lactate-and-echocardiography-before-veno-venous-extracorporeal-membrane-oxygenation-support
#19
Chiara Lazzeri, Manuela Bonizzoli, Giovanni Cianchi, Stefano Batacchi, Paolo Terenzi, Morena Cozzolino, Pasquale Bernardo, Adriano Peris
BACKGROUND: Lactate has been recognised as a prognostic factor in several critical conditions. Veno-Venous Extracorporeal Membrane Oxygenation (VV-ECMO) is a well-established therapy in patients with Acute Respiratory Disease Syndrome (ARDS) unresponsive to conventional therapy and echocardiography pre ECMO initiation has been recently reported to help in risk stratifying these patients. METHODS: We assessed whether the detection of hyperlactataemia could be associated with the presence of left ventricle (LV) or right ventricle (RV) dysfunction in 121 consecutive patients with refractory ARDS...
March 14, 2017: Heart, Lung & Circulation
https://www.readbyqxmd.com/read/28330829/does-telehealth-monitoring-identify-exacerbations-of-chronic-obstructive-pulmonary-disease-and-reduce-hospitalisations-an-analysis-of-system-data
#20
Melissa Kargiannakis, Deborah A Fitzsimmons, Claire L Bentley, Gail A Mountain
BACKGROUND: The increasing prevalence and associated cost of treating chronic obstructive pulmonary disease (COPD) is unsustainable. Health care organizations are focusing on ways to support self-management and prevent hospital admissions, including telehealth-monitoring services capturing physiological and health status data. This paper reports on data captured during a pilot randomized controlled trial of telehealth-supported care within a community-based service for patients discharged from hospital following an exacerbation of their COPD...
March 22, 2017: JMIR Medical Informatics
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