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prone position care

Hasan M Al-Dorzi, Abdulaziz S Aldawood, Raymond Khan, Salim Baharoon, John D Alchin, Amal A Matroud, Sameera M Al Johany, Hanan H Balkhy, Yaseen M Arabi
BACKGROUND: Middle East respiratory syndrome coronavirus (MERS-CoV) has caused several hospital outbreaks, including a major outbreak at King Abdulaziz Medical City, a 940-bed tertiary-care hospital in Riyadh, Saudi Arabia (August-September 2015). To learn from our experience, we described the critical care response to the outbreak. METHODS: This observational study was conducted at the Intensive Care Department which covered 5 ICUs with 60 single-bedded rooms. We described qualitatively and, as applicable, quantitatively the response of intensive care services to the outbreak...
December 2016: Annals of Intensive Care
Christian Svendsen Juhl, Martin Ballegaard, Morten H Bestle, Peer Tfelt-Hansen
Meralgia paresthetica (MP) is a mononeuropathy of the lateral femoral cutaneous nerve (LFCN) caused by external compression of the nerve during its course close to the anterior superior iliac spine. We present a case of a patient with acute respiratory distress induced by Legionella pneumonia who was admitted to the intensive care unit (ICU) for mechanical ventilation. In the ICU, the patient received one session of prone position ventilation for 8.5 consecutive hours. At evaluation six months later, the patient reported persistent bilateral numbness of the anterolateral thigh, which he complained had begun right after he woke up at the ICU...
2016: Case Reports in Critical Care
Tamara Ius, Luca Turella, Giada Pauletto, Miriam Isola, Marta Maieron, Giovanni Sciacca, Riccardo Budai, Serena D'Agostini, Roberto Eleopra, Miran Skrap
BACKGROUND: Pre-operative diffusion tensor tractography (DTT) has recently been utilized to aid in the mapping of functional pathways in order to limit damage associated with resection of low-grade gliomas. OBJECTIVE: To assess the predictive capacity of DTT as a biomarker of post-operative motor outcomes in patients with low-grade gliomas (LGGs) involving the corticospinal tract (CST). CST parameters obtained using a quantitative fiber-tracking approach were used to investigate the reliability of the DTT biomarker by comparing their values in the tumoral (Tcst) and healthy (Hcst) hemispheres...
October 12, 2016: World Neurosurgery
Adam C Johnson, John H Hollman, Benjamin M Howe, Jonathan T Finnoff
OBJECTIVE: The primary aim of this study was to determine if ischiofemoral space (IFS) dimensions vary with changes in hip flexion as a result of placing a bolster behind the knees during magnetic resonance imaging (MRI). A secondary aim was to determine if IFS dimensions vary between supine and prone hip neutral positions. DESIGN: The study employed a prospective design. SETTING: Sports medicine center within a tertiary care institution. PARTICIPANTS: Five male and five female adult subjects (age mean = 29...
October 14, 2016: Skeletal Radiology
A I Macfarlane, D Rudd, E Knight, L A G Marshman, E P Guazzo, D S Anderson
: Prior studies have suggested that elevated serum Troponin-I (TnI) levels immediately after non-cardiac surgical procedures (8-40%) represent subclinical cardiac stress which independently predicts increased 30-day mortality. Routine post-operative TnI monitoring has therefore been suggested as a standard of care. However, no prior studies have focussed on elective degenerative spine surgery, whilst few have measured pre-op TnI. Further, prolonged prone positioning could represent an additional, independent, cardiac stress...
October 1, 2016: Journal of Clinical Neuroscience: Official Journal of the Neurosurgical Society of Australasia
Young Ri Kim, Ji Won Choi, Woo Seog Sim, Chul Joong Lee, Choohoon Chang
STUDY OBJECTIVE: Elderly patients with degenerative knee disease may have accompanying degenerative spine conditions. There are no studies on lumbar epidural catheter withdrawal forces in these patients. The aim of this study was to investigate withdrawal forces and possible associated risk factors in patients undergoing total knee arthroplasty (TKA). DESIGN: Prospective randomized trial. SETTING: Operating room and ward in a university hospital...
November 2016: Journal of Clinical Anesthesia
Johanna Brännström, Veronica Svedhem, Gaetano Marrone, Örjan Andersson, Farshad Azimi, Anders Blaxhult, Anders Sönnerborg
OBJECTIVES: One quarter of HIV-1 positive individuals in Sweden present for care with HIV or AIDS associated conditions without an HIV test (missed presentations) and 16% report neglect of such symptoms. The objective of this study was to identify risk factors for these missed opportunities of HIV-1 diagnosis. METHODS: A national study, recruiting 409 newly diagnosed HIV-1 infected adults over a 2.5-year period, was performed. Logistic regression models tested the relationship between missed presentation and patient's neglect versus socio-demographic and behavioural risk factors...
2016: PloS One
Roberto Roncon-Albuquerque, João Ferreira-Coimbra, Rodrigo Vilares-Morgado, Paulo Figueiredo, José Artur Paiva
BACKGROUND: During extracorporeal membrane oxygenation (ECMO), arterial oxygen partial pressure to fractional inspired oxygen (PaO2/FiO2; PF ratio reflects native and artificial lung blood oxygenation). In this study we analyzed PF ratio during ECMO support and its association with clinical outcome. METHODS: This was a single-center observational study of adult patients (n = 81) undergoing veno-venous ECMO support for severe acute respiratory distress syndrome...
September 1, 2016: Annals of Thoracic Surgery
Andrew J Lautz, Adam C Dziorny, Adam R Denson, Kathleen A O'Connor, Marianne R Chilutti, Rachael K Ross, Jeffrey S Gerber, Scott L Weiss
OBJECTIVES: To determine whether peak blood procalcitonin (PCT) measured within 48 hours of pediatric intensive care unit (PICU) admission can differentiate severe bacterial infections from sterile inflammation and viral infection and identify potential subgroups of PICU patients for whom PCT may not have clinical utility. STUDY DESIGN: This was a retrospective, observational study of 646 critically ill children who had PCT measured within 48 hours of admission to an urban, academic PICU...
August 29, 2016: Journal of Pediatrics
Abbas Basiri, Amir H Kashi, Mehdi Zeinali, Mahmoodreza Nasiri, Reza Sarhangnejad, Reza Valipour
OBJECTIVES: To evaluate the success of ultrasonography directed renal access in entering the target calyx from proper entry site and in the direction of renal pelvis during percutaneous nephrolithotomy (PCNL). MATERIALS AND METHODS: PCNL cases who were operated on by one fellow from May-June 2014 were included in this study. A vertically placed ultrasound probe on the patient flank in prone position was used to identify the preselected target calyx. Needle was advanced through needle holder and fluoroscopy was used to document the entered calyx, site and angle of entry...
September 1, 2016: International Braz J Urol: Official Journal of the Brazilian Society of Urology
Ryoji Tauchi, Noriaki Kawakami, Taichi Tsuji, Tetsuya Ohara, Yoshitaka Suzuki, Toshiki Saito, Ayato Nohara
PURPOSE: Pectus excavatum can negatively impact cardiac function during scoliosis surgery. Several authors reported severe hypotension associated with the prone position during scoliosis surgery in children that had both scoliosis and pectus excavatum. However, we could find no studies that evaluated the change in the thoracic factors, such as sternal tilt angle and Haller index after scoliosis surgery in patients with both scoliosis and pectus excavatum. The purpose of this study is to evaluate the change in thoracic factors after surgical treatment for scoliosis associated with pectus excavatum...
August 27, 2016: European Spine Journal
Jason Phua, Nathan C Dean, Qi Guo, Win Sen Kuan, Hui Fang Lim, Tow Keang Lim
Mortality rates for severe community-acquired pneumonia (CAP) range from 17 to 48 % in published studies.In this review, we searched PubMed for relevant papers published between 1981 and June 2016 and relevant files. We explored how early and aggressive management measures, implemented within 24 hours of recognition of severe CAP and carried out both in the emergency department and in the ICU, decrease mortality in severe CAP.These measures begin with the use of severity assessment tools and the application of care bundles via clinical decision support tools...
August 28, 2016: Critical Care: the Official Journal of the Critical Care Forum
Ülkü Şermet Elbay, Husniye Demirturk Kocasarac, Mesut Elbay, Can Kaya, Ceren Uğurluel, Canan Baydemir
AIM: This study aimed: (i) to identify and compare the prevalence of temporomandibular disorders (TMDs) and oral parafunctions among children living in child-protection institutions (CLCPI) with children living with their parents (CLWP); (ii) to determine whether or not there is an association between oral parafunctions and TMDs; and (iii) to examine the possible impact of stress on TMDs. STUDY DESIGN: The study was conducted on a total of 385 children who were divided into two groups: the CLCPI group (n = 184); and the CLWP group (control, n = 201)...
August 19, 2016: International Dental Journal
Anthony LaPorta, A W Kirkpatrick, J L Mckee, D J Roberts, H Tien, A Beckett, C G Ball, I Mckee, D Louw, J B Holcomb
BACKGROUND: In a care under fire situation, a first line response to haemorrhage is to apply a tourniquet and return fire. However, there is little understanding of how tourniquets and other haemorrhage control devices impact marksmanship. METHODS: We compared the impact of the iTClamp and the Combat Application Tourniquet (CAT) on marksmanship. Following randomisation (iTClamp or CAT), trained marksmen fired an AR15 at a scaled silhouette target in prone unsupported position (shooting task)...
August 16, 2016: Journal of the Royal Army Medical Corps
C Hermes, P Nydahl, D Henzler, T Bein
The 2007 guidelines "Positioning for prophylaxis and therapy of pulmonary disorders" were completely revised in 2015 on behalf of the German Society of Anaesthesiology and Intensive Care Medicine. With regard to practical and scientific relevance, early mobilization of patients in critical care has been included in the guidelines for the first time. Furthermore, the recommendations for prone positioning have been updated, based on current evidence in medicine and nursing. In addition, recommendations regarding unsuitable positions that may actually harm patients were made...
September 2016: Medizinische Klinik, Intensivmedizin und Notfallmedizin
Sanne van Delft, Annelijn Goedhart, Mark Spigt, Bart van Pinxteren, Niek de Wit, Rogier Hopstaken
OBJECTIVE: Point-of-care testing (POCT) urinalysis might reduce errors in (subjective) reading, registration and communication of test results, and might also improve diagnostic outcome and optimise patient management. Evidence is lacking. In the present study, we have studied the analytical performance of automated urinalysis and visual urinalysis compared with a reference standard in routine general practice. SETTING: The study was performed in six general practitioner (GP) group practices in the Netherlands...
2016: BMJ Open
Berit Carow, Yu Gao, Jonathan Coquet, Marie Reilly, Martin E Rottenberg
Conditional gene targeting using the bacteriophage-derived Cre recombinase is widely applied for functional gene studies in mice. Mice transgenic for Cre under the control of the lck gene promoter are used to study the role of loxP-targeted genes in T cell development and function. In this article, we show a striking 65% reduction in cellularity, preferential development of γδ versus αβ T cells, and increased expression of IL-7R in the thymus of mice expressing Cre under the proximal lck promoter (lck-cre(+) mice)...
September 15, 2016: Journal of Immunology: Official Journal of the American Association of Immunologists
A Dobies, M Renke, W Wołyniec, L Palenicek, J Januszczyk, E Król, S Lizakowski, P Rutkowski, L Tylicki, A Dębska-Ślizień, B Rutkowski
BACKGROUND: The beneficial effect of kidney transplantation in patients requiring continuous renal replacement therapy owing to chronic kidney disease is well known and accepted. Kidney transplantation protects the patient from complications that may develop during chronic dialysis. Unfortunately, there is also evidence that kidney transplant patients are more prone to developing cancer than healthy persons. The aim of this study was to evaluate the prevalence of gastrointestinal pathologies in patients after kidney transplantation...
June 2016: Transplantation Proceedings
Chin Yee Cheong, Jane An Qi Tan, Yi-Lin Foong, Hui Mien Koh, Denise Zhen Yue Chen, Jessie Joon Chen Tan, Chong Jin Ng, Philip Yap
BACKGROUND/AIMS: The acute hospital ward can be unfamiliar and stressful for older patients with impaired cognition, rendering them prone to agitation and resistive to care. Extant literature shows that music therapy can enhance engagement and mood, thereby ameliorating agitated behaviours. This pilot study evaluates the impact of a creative music therapy (CMT) programme on mood and engagement in older patients with delirium and/or dementia (PtDD) in an acute care setting. We hypothesize that CMT improves engagement and pleasure in these patients...
May 2016: Dementia and Geriatric Cognitive Disorders Extra
Fernanda F Cruz, Daniel J Weiss, Patricia R M Rocco
INTRODUCTION: Despite progress in understanding the pathophysiology of the acute respiratory distress syndrome (ARDS), it remains a devastating clinical disorder associated with high mortality rates, and those who survive can experience significant long-term morbidity. Recent advances in the management of ARDS have mostly been achieved in supportive care, including the use of protective mechanical ventilation, neuromuscular blocking agents, prone positioning, and conservative fluid strategies...
August 4, 2016: Expert Opinion on Biological Therapy
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