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https://www.readbyqxmd.com/read/29455775/stress-cardiomyopathy-of-the-critically-ill-spectrum-of-secondary-global-probable-and-subclinical-forms
#1
REVIEW
Anand Chockalingam
Stress cardiomyopathy (SC) typically presents as potential acute coronary syndrome (ACS) in previously healthy people. While there may be physical or mental stressors, the initial symptom is usually chest pain. This form conforms to the published Mayo diagnostic criteria, is well reported and as the presentation is initially cardiac, is considered primary SC. Increasingly we see SC develop several days into the hospitalization secondary to medical or surgical critical illness. This condition is more complex, presents atypically, is not easy to recognize and carries a much worse prognosis...
January 2018: Indian Heart Journal
https://www.readbyqxmd.com/read/29448873/comparison-of-self-reported-and-behavioral-pain-assessment-tools-in-critically-ill-patients
#2
Rima H Bouajram, Christian M Sebat, Dawn Love, Erin L Louie, Machelle D Wilson, Jeremiah J Duby
BACKGROUND: Self-reported and behavioral pain assessment scales are often used interchangeably in critically ill patients due to fluctuations in mental status. The correlation between scales is not well elucidated. The purpose of this study was to describe the correlation between self-reported and behavioral pain scores in critically ill patients. METHODS: Pain was assessed using behavioral and self-reported pain assessment tools. Behavioral pain tools included Critical Care Pain Observation Tool (CPOT) and Behavioral Pain Scale (BPS)...
January 1, 2018: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/29447647/association-of-pemphigus-and-systemic-corticosteroid-use-with-comorbid-health-disorders-a-case-control-study
#3
Derek Y Hsu, Joaquin Brieva, Beatrice Nardone, Dennis West, Jonathan I Silverberg
BACKGROUND: Pemphigus is a group of debilitating autoimmune blistering disorders associated with painful blisters of the skin and/or mucous membranes. Identification and management of the comorbiditiesof pemphigus is critically important to minimize morbidity and decrease mortality. OBJECTIVE: To identify the comorbid health conditions of pemphigus vulgaris. METHODS: This was a case-control study of 130 cases of pemphigus verified by a clinical and laboratory diagnosis and 390 age and sex-matched controls with complete follow-up at a large metropolitanquaternary care medical center...
December 15, 2017: Dermatology Online Journal
https://www.readbyqxmd.com/read/29443439/complexity-of-the-relationships-of-pain-posttraumatic-stress-and-depression-in-combat-injured-populations-an-integrative-review-to-inform-evidence-based-practice
#4
Nicholas A Giordano, Christine Bader, Therese S Richmond, Rosemary C Polomano
BACKGROUND: Understanding the complex interrelationships between combat injuries, physical health, and mental health symptoms is critical to addressing the healthcare needs of wounded military personnel and veterans. The relationship between injury characteristics, pain, posttraumatic stress disorder (PTSD), and depression among combat-injured military personnel is unique to modern conflicts and understudied in the nursing literature. AIM: This integrative review synthesizes clinical presentations and relationships of combat injury, PTSD, depression, and pain in Operation Enduring Freedom (OEF) and Operation Iraqi Freedom (OIF) United States military service members and veterans...
February 14, 2018: Worldviews on Evidence-based Nursing
https://www.readbyqxmd.com/read/29437074/letting-the-patient-decide-a-case-report-of-self-administered-sedation-during-mechanical-ventilation
#5
Breanna Hetland, Sarah Maryon Hayes, Debra Skaar, Mary Fran Tracy, Craig R Weinert, Linda Chlan
It is common for critical care nurses to administer sedative medications to patients receiving mechanical ventilation. Although patient-controlled analgesia is frequently used in practice to promote effective self-management of pain by patients, it is not known if patient-controlled sedation can be used to promote effective self-management of distressing symptoms associated with mechanical ventilation. A randomized pilot trial was conducted to evaluate whether patient self-administered sedation with dexmedetomidine is safe and acceptable for self-management of anxiety during ventilator support...
February 2018: Critical Care Nurse
https://www.readbyqxmd.com/read/29428919/randomized-control-trial-comparing-pain-control-interventions-in-preterm-neonates
#6
Vivek V Shukla, Satvik Bansal, Archana Nimbalkar, Apurva Chapla, Ajay Phatak, Dipen Patel, Somashekhar Nimbalkar
OBJECTIVE: To compare individual efficacy and additive effects of pain control interventions in preterm neonates. DESIGN: Randomized controlled trial. SETTING: Level-3 University affiliated neonatal intensive care unit. PARTICIPANTS: 200 neonates (26-36 weeks gestational age) requiring heel-stick for bedside glucose assessment. Exclusion criteria were neurologic impairment and critical illness precluding study interventions...
February 9, 2018: Indian Pediatrics
https://www.readbyqxmd.com/read/29406365/acute-pain-assessment-in-sedated-patients-in-the-post-anesthesia-care-unit
#7
Sherily Pereira-Morales, Carmen Mabel Arroyo-Novoa, Annete Wysocki, Lucille Sanzero Eller
CONTEXT: Acute postoperative pain remains inadequately assessed and managed. A valid instrument that assesses acute pain in sedated Post-Anesthesia Care Unit (PACU) patients is needed. OBJECTIVES: Two behavioral pain assessment instruments, the Non-Verbal Pain Scale Revised (NVPS-R) and Critical Care Pain Observation Tool (CPOT), were used to determine if these instruments adequately assess acute pain in the PACU. METHODS: A crossover study design was used...
February 5, 2018: Clinical Journal of Pain
https://www.readbyqxmd.com/read/29404804/variation-in-emergency-department-use-of-computed-tomography-for-investigation-of-acute-aortic-dissection
#8
Robert Ohle, Omar Anjum, Helena Bleeker, George Wells, Jeffrey J Perry
INTRODUCTION: Acute aortic dissection (AAD) is a life-threatening condition making early diagnosis critical. Although 90% present with acute pain, the myriad of associated symptoms can make diagnosis a challenge. Our objective was to assess how we are using computed tomography to rule out acute aortic dissection specifically rate of ordering, diagnostic yield, and variation in practice. METHODS: We included consecutive adult patients presenting to two tertiary academic care emergency departments over one calendar year presenting with non-traumatic chest, back, abdominal, or flank pain...
February 5, 2018: Emergency Radiology
https://www.readbyqxmd.com/read/29404363/electrocardiographic-artifact-potentially-misleading-to-the-wrong-management
#9
Srishti Sareen, Mannu Nayyar, Brian Wheeler, Michelle Skelton, Rami N Khouzam
Atrial flutter (AF) is the second most common supraventricular tachyarrhythmia following atrial fibrillation. We present an interesting case of a diagnostic challenge manifested as an electrocardiogram (ECG) recording mimicking AF in a patient with Parkinson's disease (PD). A 72-year-old African-American female with history of PD presented to our Emergency Department with a one day history of chest pain. Her vital signs were within normal limits. Physical exam was remarkable for bilateral resting hand tremors at a frequency of 6-8 hertz and mild cogwheel rigidity in both upper extremities...
January 2018: Annals of Translational Medicine
https://www.readbyqxmd.com/read/29401335/influence-of-personality-traits-on-the-effective-performance-of-lifesaving-interventions-example-of-the-tourniquet-application-in-forward-combat-casualty-care
#10
Quentin Vuillemin, Pierre-Eric Schwartzbrod, Pierre Pasquier, Florian Sibille, Marion Trousselard, Marie-Hélène Ferrer
Introduction: Health care delivery in military conflicts implies high-stress environments. Hemorrhage is the first cause of survivable death among combat casualties, and tourniquet application is one of the most critical lifesaving interventions on the battlefield. However, previous studies have shown high failure rates in tourniquet application. Our study aimed to assess the correlation between personality traits that may interfere with effective tourniquet application in a simulated extremity hemorrhage...
January 1, 2018: Military Medicine
https://www.readbyqxmd.com/read/29399735/rotator-cuff-repair-post-operative-rehabilitation-concepts
#11
REVIEW
Terrance A Sgroi, Michelle Cilenti
PURPOSE OF REVIEW: With improvements in surgical techniques and increased knowledge of rotator cuff healing, there was a need to identify a safe progression after rotator cuff repair. The rehabilitation specialist plays an integral role in the care of these patients, and by implementing an evidence and criteria-based model, patients may be able to return to their prior levels of function sooner with fewer complications. RECENT FINDINGS: Timing of progression for rotator cuff patients should align not only with healing but also potential strain on the involved tissue...
February 5, 2018: Current Reviews in Musculoskeletal Medicine
https://www.readbyqxmd.com/read/29398346/measuring-acute-pain-over-time-in-the-critically-ill-using-the-multidimensional-objective-pain-assessment-tool-mopat
#12
Debra L Wiegand, Tracey Wilson, Diane Pannullo, Marguerite M Russo, Karen Snow Kaiser, Karen Soeken, Deborah B McGuire
A valid and reliable instrument is needed to assess acute pain in critically ill patients unable to self-report and who may be transitioning between critical care and other settings. To examine the reliability, validity, and clinical utility of the Multidimensional Objective Pain Assessment Tool (MOPAT) when used over time by critical care nurses to assess acute pain in non-communicative critically ill patients. Twenty-seven patients had pain assessed at two time points (T1 and T2) surrounding a painful event for up to 3 days...
February 1, 2018: Pain Management Nursing: Official Journal of the American Society of Pain Management Nurses
https://www.readbyqxmd.com/read/29395382/optimizing-insulin-delivery-for-patients-with-diabetes
#13
Naushira Pandya, Nancy Losben, Jane Moore
Management of diabetes for residents in long-term care settings is particularly challenging, due to the wide range of physical and mental limitations that bear on efficacy of their medications, as well as practical issues associated with the optimal administration of these medications. Foremost among the practical issues for residents requiring insulin injections, is the need to ensure that it is consistently delivered to the circulation at the target rate and dosage, thereby avoiding life-threatening episodes of hypoglycemia...
January 25, 2018: Geriatric Nursing
https://www.readbyqxmd.com/read/29393040/perioperative-treatment-of-patients-undergoing-acute-high-risk-abdominal-surgery%C3%A2
#14
Line Toft Tengberg
Critically ill acute high-risk abdominal surgery patients represent a major challenge to health care providers, with the typical patient being elderly and frail, and with severe and multiple comorbidities. The mortality rate in this population is high, and the postoperative course is characterized by complications, prolonged hospitalisation and considerable risk of permanent disability. With an ageing population, the number of elderly patients, as well as challenges concerning treatment will arise, calling for a coordinated effort both nationally and internationally to enhance treatment in this vulnerable patient group...
February 2018: Danish Medical Journal
https://www.readbyqxmd.com/read/29390582/a-klebsiella-pneumoniae-liver-abscess-presenting-with-myasthenia-and-tea-colored-urine-a-case-report-and-review-of-77-cases-of-bacterial-rhabdomyolysis
#15
Lihua Deng, Rong Jia, Wei Li, Qian Xue, Jie Liu, Yide Miao, Jingtong Wang
RATIONALE: Rhabdomyolysis is a well-known syndrome in clinical practice, although rhabdomyolysis caused by a liver abscess is rarely reported and the patient may lack symptoms that are associated with a primary site of infection. Early recognition of this possibility is needed to avoid diagnostic delay and facilitate treatment. We report the case of a 71-year-old woman with a Klebsiella pneumoniae (KP) pyogenic liver abscess who presented with myasthenia and tea-colored urine and also review the 77 reported cases of bacterial rhabdomyolysis...
December 2017: Medicine (Baltimore)
https://www.readbyqxmd.com/read/29387994/patient-and-oncologist-perceptions-regarding-symptoms-and-impact-on-quality-of-life-of-oral-mucositis-in-cancer-treatment-results-from-the-awareness-drives-oral-mucositis-perception-adopt-study
#16
Jeevendra Kanagalingam, Mohamed Ibrahim A Wahid, Jin-Ching Lin, Nonette A Cupino, Edward Liu, Jin-Hyoung Kang, Shouki Bazarbashi, Nicole Bender Moreira, Harsha Arumugam, Stefan Mueller, Hanlim Moon
PURPOSE: This descriptive cross-sectional survey aims to assess the level of concordance between the perspectives of oncologists and those of patients regarding oral mucositis (OM) symptoms, and the impact of OM on various aspects of daily living and concurrent cancer management. METHODS: Oncologists involved in OM management (n = 105), and patients who developed OM during cancer treatment (n = 175), were recruited from seven Asian countries. Oncologists completed a face-to-face, quantitative interview; patients completed a face-to-face interview, and a self-reported questionnaire...
January 31, 2018: Supportive Care in Cancer: Official Journal of the Multinational Association of Supportive Care in Cancer
https://www.readbyqxmd.com/read/29370321/reliability-and-validity-of-the-diagnostic-criteria-for-temporomandibular-disorders-axis-i-in-clinical-and-research-settings-a-critical-appraisal
#17
Michel H Steenks, Jens Christoph Türp, Anton de Wijer
The recently published Diagnostic Criteria for Temporomandibular Disorders (DC/TMD) Axis I, which is recommended for use in clinical and research settings, has provided an update of the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD). The authors of the DC/TMD based their publication on the results of a Validation Project (2001-2008) and consecutive workgroup sessions held between 2008 and 2013. The DC/TMD represents a major change in both content and procedures; nonetheless, earlier concerns and new insights have only partly been followed up when drafting the new recommendations...
January 2018: Journal of Oral & Facial Pain and Headache
https://www.readbyqxmd.com/read/29362274/effect-of-differentiating-exercise-guidance-based-on-a-patient-s-level-of-low-back-pain-in-primary-care-a-mixed-methods-systematic-review-protocol
#18
Jens Erik Jorgensen, Tamana Afzali, Allan Riis
INTRODUCTION: Low back pain (LBP) is one of the health conditions that lead to the most disability worldwide. Guidelines aimed at management of LBP recommend non-invasive and non-pharmacological management, including patient education, advice to stay active and exercise therapy; however, the guidelines offer no recommendation as to the allowable level of pain during exercise or how specific levels of pain should be reflected in the stage and progression of exercises or activities. The purpose of this review is to study the effect of differentiation of exercise guidance based on the level of LBP in patients in primary care...
January 23, 2018: BMJ Open
https://www.readbyqxmd.com/read/29361051/non-small-cell-lung-carcinoma-clinical-reasoning-in-the-management-of-a-patient-referred-to-physical-therapy-for-costochondritis
#19
Craig P Hensley, Alicia J Emerson
Background and Purpose: Chest pain, a frequent complaint for seeking medical care, is often attributed to musculoskeletal pathology. Costochondritis is a common disorder presenting as chest pain. Initial physical therapist examination emphasizes red flag screening. Reexamination throughout the episode of care is critical, particularly when patients are not progressing and/or in the presence of complex pain presentations. The purpose of this case report is to describe the clinical reasoning process in the management of a patient referred to physical therapy with a medical diagnosis of costochondritis...
January 18, 2018: Physical Therapy
https://www.readbyqxmd.com/read/29355951/evaluation-of-outpatient-acupuncture-for-relief-of-pregnancy-related-conditions
#20
REVIEW
Barbara Buchberger, Laura Krabbe
BACKGROUND: Acupuncture is a non-pharmacological option to relieve pregnancy-related complaints. OBJECTIVES: To critically appraise the best available evidence for the use of acupuncture in outpatient care. SEARCH STRATEGY: The MEDLINE, Cochrane Library, and Centre for Reviews and Dissemination databases were searched for English-language and German-language papers published from January 1980 to March 2017 using search terms related to pregnancy combined with 'acupuncture'...
January 21, 2018: International Journal of Gynaecology and Obstetrics
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