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https://www.readbyqxmd.com/read/29455616/is-the-fetal-cerebroplacental-ratio-better-that-the-estimated-fetal-weight-in-predicting-adverse-perinatal-outcomes-in-a-low-risk-cohort
#1
Christopher Flatley, Sailesh Kumar
OBJECTIVE: In high-risk pregnancies combining the cerebro-placental ratio (CPR) with the estimated fetal weight (EFW) improves the identification of vulnerable fetuses. The purpose of this study was to assess the CPR and EFW's ability to predict adverse obstetric and perinatal outcomes in a low-risk pregnancy, when measured late in gestation. METHODS: This was a retrospective study of women who birthed at Mater Mothers Hospitals, Brisbane, Australia between 2010 and 2015...
February 18, 2018: Journal of Maternal-fetal & Neonatal Medicine
https://www.readbyqxmd.com/read/29408748/comparison-of-outcomes-between-induction-of-labor-and-spontaneous-labor-for-term-breech-a-systemic-review-and-meta-analysis
#2
REVIEW
Wen Sun, Fen Liu, Shiliang Liu, Sara-Michelle Gratton, Darine El-Chaar, Shi Wu Wen, Dunjin Chen
OBJECTIVES: Few studies have assessed the impact of induction of labor on breech presentation. This study aims to summarize the effect of induction of labor of breech presentation on perinatal morbidity. METHODS: Literature review was done in Medline, Embase, Web of science and Cochrane Library up to 20 October 2017. Randomized control studies, cohort studies, and case control publishing studies comparing induction of labor versus spontaneous labor of singleton live breech birth were included...
December 16, 2017: European Journal of Obstetrics, Gynecology, and Reproductive Biology
https://www.readbyqxmd.com/read/29386975/balanced-fluid-versus-saline-based-fluid-in-post-operative-severe-traumatic-brain-injury-patients-acid-base-and-electrolytes-assessment
#3
Mohamad Hasyizan Hassan, Wan Mohd Nazaruddin Wan Hassan, Rhendra Hardy Mohd Zaini, Wan Fadzlina Wan Muhd Shukeri, Huda Zainal Abidin, Chong Soon Eu
Background: Normal saline (NS) is a common fluid of choice in neurosurgery and neuro-intensive care unit (ICU), but it does not contain other electrolytes and has the potential to cause hyperchloremic metabolic acidosis with prolonged infusion. These problems may be reduced with the availability of balanced fluid (BF), which becomes a more physiological isotonic solution with the presence of complete electrolyte content. This study aimed to compare the changes in electrolytes and acid-base between NS and BF (Sterofundin® ISO) therapy for post-operative severe traumatic brain injury (TBI) patients in neuro-ICU...
October 2017: Malaysian Journal of Medical Sciences: MJMS
https://www.readbyqxmd.com/read/29386170/a-social-media-based-acute-alcohol-consumption-behavior-neknomination-case-series-in-italian-emergency-departments
#4
Stefania Barbieri, Paolo Feltracco, Vittorio Lucchetta, Rosa Maria Gaudio, Alberto Tredese, Mauro Bergamini, Gianna Vettore, Vincenzo Pietrantonio, Francesco Maria Avato, Daniele Donato, Deris Gianni Boemo, Maria Vittoria Nesoti, Rossella Snenghi
BACKGROUND: NekNomination, also known as NekNominate, Neck and Nominate, or Neck Nomination, is a social network-based drinking game which is thought to have originated in Australia and spread all over the world between 2013 and 2014. Individuals record videos of themselves while rapidly drinking excessive quantities of alcoholic drinks (necking) and then nominate friends to outdo them within 24 hours; the videos are then posted on social media such as Facebook or YouTube. The consequences of this drinking game have been very dangerous; at least 5 people under age 30 years have died after drinking deadly cocktails, and many others have suffered from alcohol intoxication...
January 31, 2018: Interactive Journal of Medical Research
https://www.readbyqxmd.com/read/29340799/fully-automated-life-support-an-implementation-and-feasibility-pilot-study-in-healthy-pigs
#5
Wilfried Klingert, Jörg Peter, Christian Thiel, Karolin Thiel, Wolfgang Rosenstiel, Kathrin Klingert, Christian Grasshoff, Alfred Königsrainer, Martin Schenk
BACKGROUND: Automated systems are available in various application areas all over the world for the purpose of reducing workload and increasing safety. However, such support systems that would aid caregivers are still lacking in the medical sector. With respect to workload and safety, especially, the intensive care unit appears to be an important and challenging application field. Whereas many closed-loop subsystems for single applications already exist, no comprehensive system covering multiple therapeutic aspects and interactions is available yet...
January 16, 2018: Intensive Care Medicine Experimental
https://www.readbyqxmd.com/read/29338867/validation-of-a-definition-of-excessive-postoperative-bleeding-in-infants-undergoing-cardiac-surgery-with-cardiopulmonary-bypass
#6
Rachel S Bercovitz, Allison C Shewmake, Debra K Newman, Robert A Niebler, John P Scott, Eckehard Stuth, Pippa M Simpson, Ke Yan, Ronald K Woods
OBJECTIVE: To derive and validate an objective definition of postoperative bleeding in neonates and infants undergoing cardiac surgery with cardiopulmonary bypass. METHODS: Using a retrospective cohort of 124 infants and neonates, we included published bleeding definitions and cumulative chest tube output over different postoperative periods (eg, 2, 12, or 24 hours after intensive care unit admission) in a classification and regression tree model to determine chest tube output volumes that were associated with red blood cell transfusions and surgical re-exploration for bleeding in the first 24 hours after intensive care unit admission...
December 13, 2017: Journal of Thoracic and Cardiovascular Surgery
https://www.readbyqxmd.com/read/29324605/estimating-the-hospital-delivery-costs-associated-with-severe-maternal-morbidity-in-new-york-city-2008-2012
#7
Renata E Howland, Meghan Angley, Sang Hee Won, Wendy Wilcox, Hannah Searing, Tsu-Yu Tsao
OBJECTIVE: To quantify the average and total hospital delivery costs associated with severe maternal morbidity in excess of nonsevere maternal morbidity deliveries over a 5-year period in New York City adjusting for other sociodemographic and clinical factors. METHODS: We conducted a population-based cross-sectional study using linked birth certificates and hospital discharge data for New York City deliveries from 2008 to 2012. Severe maternal morbidity was defined using a published algorithm of International Classification of Diseases, 9 Revision, Clinical Modification disease and procedure codes...
February 2018: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/29303230/planned-birth-at-or-near-term-for-improving-health-outcomes-for-pregnant-women-with-gestational-diabetes-and-their-infants
#8
REVIEW
Linda M Biesty, Aoife M Egan, Fidelma Dunne, Eugene Dempsey, Pauline Meskell, Valerie Smith, G Meabh Ni Bhuinneain, Declan Devane
BACKGROUND: Gestational diabetes is a type of diabetes that occurs during pregnancy. Women with gestational diabetes are more likely to experience adverse health outcomes such as pre-eclampsia or polyhydramnios (excess amniotic fluid). Their babies are also more likely to have health complications such as macrosomia (birthweight > 4000 g) and being large-for-gestational age (birthweight above the 90th percentile for gestational age). Current clinical guidelines support elective birth, at or near term in women with gestational diabetes to minimise perinatal complications, especially those related to macrosomia...
January 5, 2018: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29174280/physician-staffing-needs-in-critical-care-departments
#9
V Gómez Tello, J Ruiz Moreno, M Weiss, E González Marín, P Merino de Cos, N Franco Garrobo, A Alonso Ovies, J C Montejo González, T Iber, G Marx, V Córcoles González, F Gordo Vidal, E Palencia Herrejón, J Roca Guiseris
Departments of Critical Care Medicine are characterized by high medical assistance costs and great complexity. Published recommendations on determining the needs of medical staff in the DCCM are based on low levels of evidence and attribute excessive significance to the structural/welfare approach (physician-to-beds ratio), thus generating incomplete and minimalistic information. The Spanish Society of Intensive Care Medicine and Coronary Units established a Technical Committee of experts, the purpose of which was to draft recommendations regarding requirements for medical professionals in the ICU...
November 21, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/29144182/plasma-lyte-148-vs-hartmann-s-solution-for-cardiopulmonary-bypass-pump-prime-a-prospective-double-blind-randomized-trial
#10
Laurence Weinberg, Elizabeth Chiam, James Hooper, Frank Liskaser, Angela Kim Hawkins, Denise Massie, Andrew Ellis, Chong O Tan, David Story, Rinaldo Bellomo
BACKGROUND: The mechanisms of acid-base changes during cardiopulmonary bypass (CPB) remain unclear. We tested the hypothesis that, when used as CPB pump prime solutions, Plasma-Lyte 148 (PL) and Hartmann's solution (HS) have differential mechanisms of action in their contribution to acid-base changes. METHODS: We performed a prospective, double-blind, randomized trial in adult patients undergoing elective cardiac surgery with CPB. Participants received a CPB prime solution of 2000 mL, with either PL or HS...
November 1, 2017: Perfusion
https://www.readbyqxmd.com/read/29074840/survey-regarding-attitude-of-family-about-organ-donation-after-brain-death-in-korea
#11
Hyun Ji Lee, Myung Jae Jin, Sang Youb Han, Kum Hyun Han, Se Won Oh, Hye-Yeon Jang, Ui Jun Park, Hyoung Tae Kim, Young-Nam Roh
BACKGROUND This study examined the attitude of patients' relatives in South Korea toward organ donation after brain death. MATERIAL AND METHODS A structured questionnaire was used to obtain the information on the attitude toward organ donation for relatives of patients who were admitted to the surgical intensive care unit (SICU) between March 1, 2014 and September 30, 2016. In total, 92 persons participated voluntarily. The investigation included general opinion about organ donation; and additional categorical analysis was performed...
October 27, 2017: Annals of Transplantation: Quarterly of the Polish Transplantation Society
https://www.readbyqxmd.com/read/29055663/damage-control-concept-and-implementation
#12
B Malgras, B Prunet, X Lesaffre, G Boddaert, S Travers, P-J Cungi, E Hornez, O Barbier, H Lefort, S Beaume, M Bignand, J Cotte, P Esnault, J-L Daban, J Bordes, E Meaudre, J-P Tourtier, S Gaujoux, S Bonnet
The concept of damage control (DC) is based on a sequential therapeutic strategy that favors physiological restoration over anatomical repair in patients presenting acutely with hemorrhagic trauma. Initially described as damage control surgery (DCS) for war-wounded patients with abdominal penetrating hemorrhagic trauma, this concept is articulated in three steps: surgical control of lesions (hemostasis, sealing of intestinal spillage), physiological restoration, then surgery for definitive repair. This concept was quickly adapted for intensive care management under the name damage control resuscitation (DCR), which refers to the modalities of hospital resuscitation carried out in patients suffering from traumatic hemorrhagic shock within the context of DCS...
December 2017: Journal of Visceral Surgery
https://www.readbyqxmd.com/read/29033075/multi-drug-resistant-organism-infections-in-a-medical-icu-association-to-clinical-features-and-impact-upon-outcome
#13
E E Magira, S Islam, M S Niederman
OBJECTIVE: To define clinical features associated with Intensive Care Unit (ICU) infections caused by multi-drug resistant organisms (MDRO) and their impact on patient outcome. DESIGN: A single-center, retrospective case-control study was carried out between January 2010 and May 2010. SETTING: A medical ICU (MICU) in the United States. PATIENTS: The study included a total of 127 MDRO-positive patients and 186 MDRO-negative patients...
October 12, 2017: Medicina Intensiva
https://www.readbyqxmd.com/read/29016485/a-medically-supervised-pregnancy-exercise-intervention-in-obese-women-a-randomized-controlled-trial
#14
RANDOMIZED CONTROLLED TRIAL
Niamh Daly, Maria Farren, Aoife McKeating, Ruth OʼKelly, Mary Stapleton, Michael J Turner
OBJECTIVE: To evaluate whether an intensive, medically supervised exercise intervention improved maternal glycemia and gestational weight gain in obese pregnant women when compared with routine prenatal care. METHODS: This randomized controlled trial compared a medically supervised exercise intervention with routine prenatal care. The primary outcome was a reduction in mean maternal fasting plasma glucose in the intervention group by 6.9 mg/dL at the time of a 75-g oral glucose tolerance test at 24-28 weeks of gestation...
November 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28977759/the-role-of-danger-signals-in-the-pathogenesis-and-perpetuation-of-critical-illness
#15
Kevin C Ma, Edward J Schenck, Maria A Pabon, Augustine M K Choi
The innate immune system induces inflammation through induction of multiple pathways including the TNFα/NF-κB signaling as well as the NLRP3 inflammasome cascade activation with production of inflammatory molecules. Pathogen associated molecular patterns are immunogenic costimulatory molecules that can activate the innate immune system in the presence of foreign pathogens. These molecularly distinct, foreign, particles initiate inflammatory and cell death cascades of the innate immune response through the binding of pathogen recognition receptors such as toll like receptors...
October 4, 2017: American Journal of Respiratory and Critical Care Medicine
https://www.readbyqxmd.com/read/28965053/point-of-care-testing-for-streptomycin-based-on-aptamer-recognizing-and-digital-image-colorimetry-by-smartphone
#16
Bixia Lin, Ying Yu, Yujuan Cao, Manli Guo, Debin Zhu, Jiaxing Dai, Minshi Zheng
The rapid detection of antibiotic residual in everyday life is very important for food safety. In order to realize the on-site and visual detection of antibiotic, a POCT method was established by using digital image colorimetry based on smartphone. Streptomycin was taken as the analyte model of antibiotics, streptomycin aptamer preferentially recognized analyte, and the excess aptamer hybridized with the complementary DNA to form the dsDNA. SYBR Green I combined with the dsDNA and then emitted obvious green fluorescence, thus the fluorescence intensity decreased with the increasing of streptomycin concentration...
September 20, 2017: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/28930959/outcomes-after-concomitant-traumatic-brain-injury-and-hemorrhagic-shock-a-secondary-analysis-from-the-pragmatic-randomized-optimal-platelets-and-plasma-ratios-trial
#17
RANDOMIZED CONTROLLED TRIAL
Samuel M Galvagno, Erin E Fox, Savitri N Appana, Sarah Baraniuk, Patrick L Bosarge, Eileen M Bulger, Rachel A Callcut, Bryan A Cotton, Michael Goodman, Kenji Inaba, Terence O'Keeffe, Martin A Schreiber, Charles E Wade, Thomas M Scalea, John B Holcomb, Deborah M Stein
BACKGROUND: Often the clinician is faced with a diagnostic and therapeutic dilemma in patients with concomitant traumatic brain injury (TBI) and hemorrhagic shock (HS), as rapid deterioration from either can be fatal. Knowledge about outcomes after concomitant TBI and HS may help prioritize the emergent management of these patients. We hypothesized that patients with concomitant TBI and HS (TBI + HS) had worse outcomes and required more intensive care compared with patients with only one of these injuries...
October 2017: Journal of Trauma and Acute Care Surgery
https://www.readbyqxmd.com/read/28904962/self-rated-health-as-a-predictor-of-death-after-two-years-the-importance-of-physical-and-mental-wellbeing-postintensive-care
#18
Marie Vejen, Jakob B Bjorner, Morten H Bestle, Anne Lindhardt, Jens U Jensen
INTRODUCTION: The objective of this study is, among half-year intensive care survivors, to determine whether self-assessment of health can predict two-year mortality. METHODS: The study is a prospective cohort study based on the Procalcitonin and Survival Study trial. Half-year survivors from this 1200-patient multicenter intensive care trial were sent the SF-36 questionnaire. We used both a simple one-item question and multiple questions summarized as a Physical Component Summary (PCS) and a Mental Component Summary (MCS) score...
2017: BioMed Research International
https://www.readbyqxmd.com/read/28903892/effectiveness-of-smartmoms-a-novel-ehealth-intervention-for-management-of-gestational-weight-gain-randomized-controlled-pilot-trial
#19
Leanne M Redman, L Anne Gilmore, Jeffrey Breaux, Diana M Thomas, Karen Elkind-Hirsch, Tiffany Stewart, Daniel S Hsia, Jeffrey Burton, John W Apolzan, Loren E Cain, Abby D Altazan, Shelly Ragusa, Heather Brady, Allison Davis, J Mick Tilford, Elizabeth F Sutton, Corby K Martin
BACKGROUND: Two-thirds of pregnant women exceed gestational weight gain (GWG) recommendations. Because excess GWG is associated with adverse outcomes for mother and child, development of scalable and cost-effective approaches to deliver intensive lifestyle programs during pregnancy is urgent. OBJECTIVE: The aim of this study was to decrease the proportion of women who exceed the Institute of Medicine (IOM) 2009 GWG guidelines. METHODS: In a parallel-arm randomized controlled trial, 54 pregnant women (age 18-40 years) who were overweight (n=25) or obese (n=29) were enrolled to test whether an intensive lifestyle intervention (called SmartMoms) decreased the proportion of women with excess GWG, defined as exceeding the 2009 IOM guidelines, compared to no intervention (usual care group)...
September 13, 2017: JMIR MHealth and UHealth
https://www.readbyqxmd.com/read/28891977/polytrauma-defined-by-the-new-berlin-definition-a-validation-test-based-on-propensity-score-matching-approach
#20
Cheng-Shyuan Rau, Shao-Chun Wu, Pao-Jen Kuo, Yi-Chun Chen, Peng-Chen Chien, Hsiao-Yun Hsieh, Ching-Hua Hsieh
Background: Polytrauma patients are expected to have a higher risk of mortality than that obtained by the summation of expected mortality owing to their individual injuries. This study was designed to investigate the outcome of patients with polytrauma, which was defined using the new Berlin definition, as cases with an Abbreviated Injury Scale (AIS) ≥ 3 for two or more different body regions and one or more additional variables from five physiologic parameters (hypotension [systolic blood pressure ≤ 90 mmHg], unconsciousness [Glasgow Coma Scale score ≤ 8], acidosis [base excess ≤ -6...
September 11, 2017: International Journal of Environmental Research and Public Health
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