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https://www.readbyqxmd.com/read/28624388/geo-economic-variations-in-epidemiology-patterns-of-care-and-outcomes-in-patients-with-acute-respiratory-distress-syndrome-insights-from-the-lung-safe-prospective-cohort-study
#1
John G Laffey, Fabiana Madotto, Giacomo Bellani, Tài Pham, Eddy Fan, Laurent Brochard, Pravin Amin, Yaseen Arabi, Ednan K Bajwa, Alejandro Bruhn, Vladimir Cerny, Kevin Clarkson, Leo Heunks, Kiyoyasu Kurahashi, Jon Henrik Laake, Jose A Lorente, Lia McNamee, Nicolas Nin, Jose Emmanuel Palo, Lise Piquilloud, Haibo Qiu, Juan Ignacio Silesky Jiménez, Andres Esteban, Daniel F McAuley, Frank van Haren, Marco Ranieri, Gordon Rubenfeld, Hermann Wrigge, Arthur S Slutsky, Antonio Pesenti
BACKGROUND: Little information is available about the geo-economic variations in demographics, management, and outcomes of patients with acute respiratory distress syndrome (ARDS). We aimed to characterise the effect of these geo-economic variations in patients enrolled in the Large Observational Study to Understand the Global Impact of Severe Acute Respiratory Failure (LUNG SAFE). METHODS: LUNG SAFE was done during 4 consecutive weeks in winter, 2014, in a convenience sample of 459 intensive-care units in 50 countries across six continents...
June 14, 2017: Lancet Respiratory Medicine
https://www.readbyqxmd.com/read/28602752/analysis-of-complications-of-prone-position-in-acute-respiratory-distress-syndrome-quality-standard-incidence-and-related-factors
#2
E Jové Ponseti, A Villarrasa Millán, D Ortiz Chinchilla
INTRODUCTION: The monitoring system based on standards of quality allows clinicians to evaluate and improve the patient's care. According to the quality indicators recommended by Sociedad Española de Medicina Intensiva Crítica y Unidades Coronarias, and due to the importance of prone position (PP) as a treatment in patients with acute respiratory distress syndrome, it is fundamental to keep accurate record of serious adverse events occurring during the prone position procedure and its posterior analysis...
June 8, 2017: Enfermería Intensiva
https://www.readbyqxmd.com/read/28601711/identification-of-qrs-complex-in-non-stationary-electrocardiogram-of-sick-infants
#3
S Kota, C B Swisher, T Al-Shargabi, N Andescavage, A du Plessis, R B Govindan
BACKGROUND: Due to the high-frequency of routine interventions in an intensive care setting, electrocardiogram (ECG) recordings from sick infants are highly non-stationary, with recurrent changes in the baseline, alterations in the morphology of the waveform, and attenuations of the signal strength. Current methods lack reliability in identifying QRS complexes (a marker of individual cardiac cycles) in the non-stationary ECG. In the current study we address this problem by proposing a novel approach to QRS complex identification...
June 2, 2017: Computers in Biology and Medicine
https://www.readbyqxmd.com/read/28566172/pattern-of-care-and-outcome-in-elderly-patients-with-glioblastoma-data-in-151-patients-from-3-lombardia-hospitals
#4
Andrea Rigamonti, Francesca Imbesi, Antonio Silvani, Gianluca Grimod, Valentina Prone, Paola Gaviani, Antonio Ardizzoia, Ida Milanesi, Virginia Arienti, Elio Agostoni, Francesco Di Meco, Andrea Salmaggi
The appropriate treatment approach for elderly patients with glioblastoma multiforme (GBM) is unclear, although different studies suggest survival benefit in fit patients treated with radiotherapy and chemiotherapy after surgery. We performed a retrospective analysis of 151 patients older than 65years with GBM treated in 3 Lombardia Hospitals. In univariate regression analysis higher KPS (p=0.02), macroscopical total resection (p<0.003), radiotherapy (p<0.0001), chemotherapy (p<0.0001) and second line chemotheraphy (p=0...
July 15, 2017: Journal of the Neurological Sciences
https://www.readbyqxmd.com/read/28550421/pre-emptive-triple-tributary-internal-iliac-vein-ligation-reduces-catastrophic-haemorrhage-from-sacrectomy-during-pelvic-exenterative-surgery
#5
D J Coker, K K S Austin, A A Eyers, C J Young
BACKGROUND: The risk of significant haemorrhage in pelvic exenterative surgery requiring sacrectomy has been well described. Patients requiring a sacrectomy above S3 are placed in the prone position, posing an increased challenge to gaining control of haemorrhage when it occurs. We describe a technique of pre-emptive control of the internal iliac vein and its three named tributaries to tame the pelvis prior to sacrectomy. METHODS: A retrospective, descriptive analysis was performed on a cohort of 25 consecutive patients operated on by one of the authors (AA E) between January 2005 and December 2010; all of whom underwent pre-emptive internal iliac vein triple tributary venous ligation, either unilaterally or bilaterally prior to sacrectomy above the level of S3...
May 26, 2017: Techniques in Coloproctology
https://www.readbyqxmd.com/read/28538549/impact-of-evolving-radiation-therapy-techniques-on-implant-based-breast-reconstruction
#6
Horatiu Muresan, Gretl Lam, Benjamin T Cooper, Carmen A Perez, Alexes Hazen, Jamie P Levine, Pierre B Saadeh, Mihye Choi, Nolan S Karp, Daniel J Ceradini
BACKGROUND: Patients undergoing implant-based reconstruction in the setting of postmastectomy radiation therapy suffer from increased complications and inferior outcomes compared with those not irradiated, but advances in radiation delivery have allowed for more nuanced therapy. The authors investigated whether these advances impact patient outcomes in implant-based breast reconstruction. METHODS: Retrospective chart review identified all implant-based reconstructions performed at a single institution from November of 2010 to November of 2013...
June 2017: Plastic and Reconstructive Surgery
https://www.readbyqxmd.com/read/28514804/-changes-in-the-use-of-health-insurance-services-before-and-after-a-father-child-measure
#7
Felix Barre, Jelena Epping
Introduction Since 2002 inpatient preventive and rehabilitative measures for fathers and their children (F-C-M) are available in the German health system (§§ 24 and 41 SGB V). So far there is no data on health disorders of the fathers in F-C-M. The aim of this study is to examine whether participants of F-C-M are more prone to health problems than fathers who are not participating in F-C-M and whether participation in F-C-M contributes to improved health. To do so, the change in the use of outpatient care services is examined and compared to the use of mentioned services by fathers who are not participating in an F-C-M...
May 17, 2017: Das Gesundheitswesen
https://www.readbyqxmd.com/read/28496141/a-randomized-comparison-of-the-prone-ventilation-endotracheal-tube-versus-the-traditional-endotracheal-tube-in-adult-patients-undergoing-prone-position-surgery
#8
Wangyuan Zou, Jiali Shao, Xia Liang, Lin Li, Zhenghua He, Qulian Guo
Endotracheal tube displacement or dislocation is a severe complication that can occur in patients who require prone position ventilation. We hypothesized the prone position tube (PPT) would reduce the incidence of displacement of an endotracheal tube in an adult prone operation compared to a traditional tube (TT). A total of 80 adult patients undergoing neurosurgery or spine surgery were recruited. Sixty patients with prone position ventilation were randomly divided into the traditional routine endotracheal tube group (Group TT, n = 30) and the prone position ventilation endotracheal tube group (Group PPT, n = 30)...
May 11, 2017: Scientific Reports
https://www.readbyqxmd.com/read/28492707/the-strangest-of-all-encounters-racial-and-ethnic-discrimination-in-us-health-care
#9
Sherman A James
In 2003, a Committee of the Institute of Medicine of the National Academy of Sciences summarized hundreds of studies documenting that US racial minorities, especially African Americans, receive poorer quality health care for a wide variety of conditions than their White counterparts. These racial differences in health care persist after controlling for sociodemographic factors and patients' ability to pay for care. The Committee concluded that physicians' unconscious negative stereotypes of African Americans, and perhaps other people of color, likely contribute to these health care disparities...
May 8, 2017: Cadernos de Saúde Pública
https://www.readbyqxmd.com/read/28490484/developing-a-decision-rule-to-optimise-clinical-pharmacist-resources-for-medication-reconciliation-in-the-emergency-department
#10
Sabrina De Winter, Peter Vanbrabant, Pieter Laeremans, Veerle Foulon, Ludo Willems, Sandra Verelst, Isabel Spriet
BACKGROUND: The process of obtaining a complete medication history for patients admitted to the hospital from the ED at hospital admission, without discrepancies, is error prone and time consuming. OBJECTIVES: The goal of this study was the development of a clinical decision rule (CDR) with a high positive predictive value in detecting ED patients admitted to hospital at risk of at least one discrepancy during regular medication history acquisition, along with favourable feasibility considering time and budget constraints...
May 10, 2017: Emergency Medicine Journal: EMJ
https://www.readbyqxmd.com/read/28478848/the-role-of-psychological-factors-in-oncology-nurses-burnout-and-compassion-fatigue-symptoms
#11
Joana Duarte, José Pinto-Gouveia
PURPOSE: This study explored the role of several psychological factors in professional quality of life in nurses. Specifically, we tried to clarify the relationships between several dimensions of empathy, self-compassion, and psychological inflexibility, and positive (compassion satisfaction) and negative (burnout and compassion fatigue) domains of professional quality of life. METHODS: Using a cross-sectional design, a convenience sample of 221 oncology nurses recruited from several public hospitals filling out a battery of self-report measures...
June 2017: European Journal of Oncology Nursing: the Official Journal of European Oncology Nursing Society
https://www.readbyqxmd.com/read/28459336/an-official-american-thoracic-society-european-society-of-intensive-care-medicine-society-of-critical-care-medicine-clinical-practice-guideline-mechanical-ventilation-in-adult-patients-with-acute-respiratory-distress-syndrome
#12
Eddy Fan, Lorenzo Del Sorbo, Ewan C Goligher, Carol L Hodgson, Laveena Munshi, Allan J Walkey, Neill K J Adhikari, Marcelo B P Amato, Richard Branson, Roy G Brower, Niall D Ferguson, Ognjen Gajic, Luciano Gattinoni, Dean Hess, Jordi Mancebo, Maureen O Meade, Daniel F McAuley, Antonio Pesenti, V Marco Ranieri, Gordon D Rubenfeld, Eileen Rubin, Maureen Seckel, Arthur S Slutsky, Daniel Talmor, B Taylor Thompson, Hannah Wunsch, Elizabeth Uleryk, Jan Brozek, Laurent J Brochard
BACKGROUND: This document provides evidence-based clinical practice guidelines on the use of mechanical ventilation in adult patients with acute respiratory distress syndrome (ARDS). METHODS: A multidisciplinary panel conducted systematic reviews and metaanalyses of the relevant research and applied Grading of Recommendations, Assessment, Development, and Evaluation methodology for clinical recommendations. RESULTS: For all patients with ARDS, the recommendation is strong for mechanical ventilation using lower tidal volumes (4-8 ml/kg predicted body weight) and lower inspiratory pressures (plateau pressure < 30 cm H2O) (moderate confidence in effect estimates)...
May 1, 2017: American Journal of Respiratory and Critical Care Medicine
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
#13
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/28435114/the-decussating-fibers-of-the-lumbar-thoracolumbar-fascia-a-landmark-for-identifying-the-l5-spinous-process
#14
Fernando Alonso, Tarush Rustagi, Christian Fisahn, Doniel Drazin, Brady Gardner, Joe Iwanaga, Jens R Chapman, Rod J Oskouian, R Shane Tubbs
INTRODUCTION: The thoracolumbar fascia has been well studied and is known to have crisscrossing fibers. Based on surgical experience, we have hypothesized that the decussating fibers of this fascia may indicate a specific vertebral level. Therefore, the following anatomical study was performed. METHODS: Twenty adult fresh frozen cadavers aged 72-84 years old at death were placed in the prone position and the skin of the lumbar and upper sacrum was removed. Careful attention was given to the thoracolumbar fascia and any fibers of it that grossly crossed the midline to inderdigitate with its contralateral counterpart...
April 20, 2017: World Neurosurgery
https://www.readbyqxmd.com/read/28431333/regeneration-and-health-a-structured-rapid-literature-review
#15
REVIEW
G McCartney, W Hearty, M Taulbut, R Mitchell, R Dryden, C Collins
OBJECTIVE: To identify and synthesise what is known about the impacts of regeneration on health, health inequalities and their socio-economic determinants. STUDY DESIGN: Rapid, structured literature review. METHODS: A rapid, structured approach was undertaken to identifying relevant studies involving a search of peer-reviewed literature databases, an Internet search to identify relevant grey literature, and a review of articles citing two key systematic reviews...
July 2017: Public Health
https://www.readbyqxmd.com/read/28407306/the-influence-of-the-emergence-profile-on-the-amount-of-undetected-cement-excess-after-delivery-of-cement-retained-implant-reconstructions
#16
M Sancho-Puchades, D Crameri, M Özcan, I Sailer, R E Jung, C H F Hämmerle, D S Thoma
OBJECTIVE: To test whether or not one of two emergence profile designs (concave or convex) is superior to the other in terms of remaining cement following cementation of reconstructions on individualized abutments and careful cement removal. MATERIALS AND METHODS: A central incisor with a single implant-supported reconstruction was selected as a model. Six types of abutments (n = 10) with two different emergence profile designs (concave (CC) and convex (CV)) and three crown-abutment margin depths (epimucosal, 1...
April 13, 2017: Clinical Oral Implants Research
https://www.readbyqxmd.com/read/28378030/potassium-regulation-in-the-neonate
#17
Melvin Bonilla-Félix
Potassium, the major cation in intracelluar fluids, is essential for vital biological functions. Neonates maintain a net positive potassium balance, which is fundamental to ensure somatic growth but places these infants, especially those born prematurely, at risk for life-threatening disturbances in potassium concentration [K(+)] in the extracellular fluid compartment. Potassium conservation is achieved by maximizing gastrointestinal absorption and minimizing renal losses. A markedly low glomerular filtration rate, plus adaptations in tubular transport along the nephron, result in low potassium excretion in the urine of neonates...
April 4, 2017: Pediatric Nephrology: Journal of the International Pediatric Nephrology Association
https://www.readbyqxmd.com/read/28374901/the-impact-of-carbapenem-resistance-on-clinical-deterioration-and-mortality-in-patients-with-liver-disease
#18
Philip G Ferstl, Natalie Filmann, Christian Brandt, Stefan Zeuzem, Michael Hogardt, Volkhard A J Kempf, Mona Müller, Oliver Waidmann, Claudia Reinheimer
BACKGROUND & AIMS: Infections with multidrug-resistant gram-negative bacteria are significantly impairing the prognosis of patients with liver disease. In particular, carbapenem resistance further narrows therapeutic options. This study investigates the impact of carbapenem-resistant gram-negative bacteria on the outcome of patients with liver disease and cirrhosis. METHODS: Between January 2011 and July 2015, 132 patients treated at the tertiary liver transplant centre at University Hospital Frankfurt, Germany, were tested positive for carbapenem-resistant gram-negative bacteria and retrospectively analysed in this study...
April 4, 2017: Liver International: Official Journal of the International Association for the Study of the Liver
https://www.readbyqxmd.com/read/28372905/apoe-%C3%AE%C2%B54-positive-patients-suffering-severe-traumatic-head-injury-are-more-prone-to-undergo-decompressive-hemicraniectomy
#19
Zandra Olivecrona, Lars-Owe D Koskinen
OBJECT: In this paper we tested the hypothesis if patients with severe traumatic brain injury and presence of the apolipoprotein E (APOE) ε4 allele are more prone to undergo the surgical procedure decompressive hemicraniectomy (DC) in order to bring the intracranial pressure (ICP) under control. METHODS: In this prospective consecutive study patients with sTBI were enrolled (n=48). Inclusion criteria were arrival to our level one trauma university hospital within 24h after trauma, patient age between 15 and 70years, Glasgow Coma Scale (GCS) score ≤8 at the time of intubation and sedation, an initial cerebral perfusion pressure >10mmHg...
March 31, 2017: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
https://www.readbyqxmd.com/read/28366715/twenty-years-of-anesthetic-and-perioperative-management-of-patients-with-tetralogy-of-fallot-with-absent-pulmonary-valve
#20
John D Jochman, Douglas B Atkinson, Luis G Quinonez, Morgan L Brown
OBJECTIVE: Review the authors' institutional experience of the induction and perioperative airway management of children with tetralogy of Fallot with an absent pulmonary valve. DESIGN: Retrospective chart review. SETTING: Large academic children's hospital. PARTICIPANTS: Patients with the diagnosis of tetralogy of Fallot with absent pulmonary valve undergoing primary cardiac repair over a 20-year period. INTERVENTIONS: None...
February 4, 2017: Journal of Cardiothoracic and Vascular Anesthesia
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