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https://www.readbyqxmd.com/read/29051895/chronic-lymphocytic-leukemia-a-rare-cause-of-pathological-fracture-of-the-femur
#1
Parita Soni, Nidhi Aggarwal, Anand Rai, Vivek Kumar, Kamholz Stephan, Yoon Taek, Kupfer Yizhak
The incidence rate of chronic lymphocytic leukemia (CLL) in the United States is approximately 0.005%; men are at slightly higher risk than women. Bony involvement or pathological fracture rarely occurs in CLL, and it may be the initial presentation. An 85-year-old woman presented with acute respiratory failure secondary to pneumonia. Symptomatology included dyspnea. She was found to have pathological fracture of the femur caused by CLL. The diagnosis of CLL had been made 6 years previously, but the patient had refused therapy...
October 2017: Journal of Investigative Medicine High Impact Case Reports
https://www.readbyqxmd.com/read/29045255/listening-to-relaxing-music-improves-physiological-responses-in-premature-infants-a-randomized-controlled-trial
#2
Rafael A Caparros-Gonzalez, Alejandro de la Torre-Luque, Carolina Diaz-Piedra, Francisco J Vico, Gualberto Buela-Casal
BACKGROUND: Premature infants are exposed to high levels of noise in the neonatal intensive care unit (NICU). PURPOSE: This study evaluated the effect of a relaxing music therapy intervention composed by artificial intelligence on respiratory rate, systolic and diastolic blood pressure, and heart rate. METHODS: A double-blind, randomized, controlled trial was conducted in the NICUs of 2 general public hospitals in Andalusia, Spain. Participants were 17 healthy premature infants, randomly allocated to the intervention group or the control group (silence) at a 1:1 ratio...
October 17, 2017: Advances in Neonatal Care: Official Journal of the National Association of Neonatal Nurses
https://www.readbyqxmd.com/read/29042462/infrequent-provision-of-palliative-care-to-patients-with-dialysis-requiring-aki
#3
Kelly Chong, Samuel A Silver, Jin Long, Yuanchao Zheng, V Shane Pankratz, Mark L Unruh, Glenn M Chertow
BACKGROUND AND OBJECTIVES: The use of palliative care in AKI is not well described. We sought to better understand palliative care practice patterns for hospitalized patients with AKI requiring dialysis in the United States. DESIGN, SETTING, PARTICIPANTS, & MEASUREMENTS: Using the 2012 National Inpatient Sample, we identified patients with AKI and palliative care encounters using validated International Classification of Diseases, Ninth Revision, Clinical Modification codes...
October 17, 2017: Clinical Journal of the American Society of Nephrology: CJASN
https://www.readbyqxmd.com/read/29037960/effect-of-procalcitonin-guided-antibiotic-treatment-on-mortality-in-acute-respiratory-infections-a-patient-level-meta-analysis
#4
Philipp Schuetz, Yannick Wirz, Ramon Sager, Mirjam Christ-Crain, Daiana Stolz, Michael Tamm, Lila Bouadma, Charles E Luyt, Michel Wolff, Jean Chastre, Florence Tubach, Kristina B Kristoffersen, Olaf Burkhardt, Tobias Welte, Stefan Schroeder, Vandack Nobre, Long Wei, Heiner C Bucher, Djillali Annane, Konrad Reinhart, Ann R Falsey, Angela Branche, Pierre Damas, Maarten Nijsten, Dylan W de Lange, Rodrigo O Deliberato, Carolina F Oliveira, Vera Maravić-Stojković, Alessia Verduri, Bianca Beghé, Bin Cao, Yahya Shehabi, Jens-Ulrik S Jensen, Caspar Corti, Jos A H van Oers, Albertus Beishuizen, Armand R J Girbes, Evelien de Jong, Matthias Briel, Beat Mueller
BACKGROUND: In February, 2017, the US Food and Drug Administration approved the blood infection marker procalcitonin for guiding antibiotic therapy in patients with acute respiratory infections. This meta-analysis of patient data from 26 randomised controlled trials was designed to assess safety of procalcitonin-guided treatment in patients with acute respiratory infections from different clinical settings. METHODS: Based on a prespecified Cochrane protocol, we did a systematic literature search on the Cochrane Central Register of Controlled Trials, MEDLINE, and Embase, and pooled individual patient data from trials in which patients with respiratory infections were randomly assigned to receive antibiotics based on procalcitonin concentrations (procalcitonin-guided group) or control...
October 13, 2017: Lancet Infectious Diseases
https://www.readbyqxmd.com/read/29036487/prospective-and-retrospective-evaluation-of-the-performance-of-the-fda-approved-cepheid-xpert-flu-rsv-xc-assay
#5
Sophie Arbefeville, Elizabeth Thonen-Kerr, Patricia Ferrieri
Rapid and accurate detection of respiratory viruses is important in patient care and in guiding therapy and infection prevention policy. Rapid viral antigen assays are simple to perform and provide results within 15 to 30 minutes but are limited by their modest-to-moderate sensitivity. Molecular assays are more sensitive and specific but require more technical time and expertise and are more expensive. We verified the performance of the Xpert Flu/RSV XC assay prospectively, using patient respiratory samples from the 2014-2015 respiratory season, and, retrospectively, with frozen patient samples from the previous respiratory season...
September 29, 2017: Laboratory Medicine
https://www.readbyqxmd.com/read/29035924/rotational-therapy-in-thoracic-injuries-what-is-the-evidence
#6
Philipp Störmann, Ingo Marzi, Sebastian Wutzler
PURPOSE OF REVIEW: To review the current use of continuous lateral rotational therapy (CLRT) in patients with thoracic injuries and its impact on clinical course, complications and outcome. RECENT FINDINGS: Patient positioning is a key factor in the treatment of severe thoracic injuries and CLRT, and intermittent supine and prone position are basic options. There is a lack of randomized controlled studies for trauma patients with chest injury undergoing kinetic therapy as standard of care...
October 14, 2017: Current Opinion in Critical Care
https://www.readbyqxmd.com/read/29029685/using-structured-and-unstructured-data-to-identify-patients-need-for-services-that-address-the-social-determinants-of-health
#7
Joshua R Vest, Shaun J Grannis, Dawn P Haut, Paul K Halverson, Nir Menachemi
INTRODUCTION: Increasingly, health care providers are adopting population health management approaches that address the social determinants of health (SDH). However, effectively identifying patients needing services that address a SDH in primary care settings is challenging. The purpose of the current study is to explore how various data sources can identify adult primary care patients that are in need of services that address SDH. METHODS: A cross-sectional study described patients in need of SDH services offered by a safety-net hospital's federally qualified health center clinics...
November 2017: International Journal of Medical Informatics
https://www.readbyqxmd.com/read/29026843/melatonin-supplementation-may-improve-the-outcome-of-patients-with-hemorrhagic-stroke-in-the-intensive-care-unit
#8
Mehrnoush Dianatkhah, Atabak Najafi, Mohammad Sharifzadeh, Arezoo Ahmadi, Hamidreza Sharifnia, Mojtaba Mojtahedzadeh, Farhad Najmeddin, Azadeh Moghaddas
OBJECTIVE: Although mechanical ventilation is frequently a life-saving therapy, its use can result in unwanted side effects. It has been well documented that the choice of sedating agent may influence the duration of mechanical ventilation. Melatonin is a sedative and analgesic agent without any respiratory depressant effect which makes it an attractive adjuvant for sedation in the intubated patients. The aim of this study is to evaluate the effect of melatonin on the duration of mechanical ventilation in patients with hemorrhagic stroke...
July 2017: Journal of Research in Pharmacy Practice
https://www.readbyqxmd.com/read/29026410/the-effect-of-reflexotherapy-and-massage-therapy-on-vital-signs-and-stress-before-coronary-angiography-an-open-label-clinical-trial
#9
Ali Khaledifar, Marzeih Nasiri, Borzoo Khaledifar, Arsalan Khaledifar, Ali Mokhtari
BACKGROUND: Complementary medicine interventions are now successfully used to reduce stress as well as to stabilize hemodynamic indices within different procedures. The present study aimed to examine the effect of massage therapy and reflexotherapy on reducing stress in patients before coronary angiography. METHODS: In this open-label clinical trial, 75 consecutive patients who were candidate for coronary angiography were randomly assigned to receive reflexotherapy (n = 25), or massage therapy (n = 25), or routine care (n = 25) before angiography...
March 2017: ARYA Atherosclerosis
https://www.readbyqxmd.com/read/29025194/procalcitonin-to-initiate-or-discontinue-antibiotics-in-acute-respiratory-tract-infections
#10
REVIEW
Philipp Schuetz, Yannick Wirz, Ramon Sager, Mirjam Christ-Crain, Daiana Stolz, Michael Tamm, Lila Bouadma, Charles E Luyt, Michel Wolff, Jean Chastre, Florence Tubach, Kristina B Kristoffersen, Olaf Burkhardt, Tobias Welte, Stefan Schroeder, Vandack Nobre, Long Wei, Heiner C Bucher, Neera Bhatnagar, Djillali Annane, Konrad Reinhart, Angela Branche, Pierre Damas, Maarten Nijsten, Dylan W de Lange, Rodrigo O Deliberato, Stella Ss Lima, Vera Maravić-Stojković, Alessia Verduri, Bin Cao, Yahya Shehabi, Albertus Beishuizen, Jens-Ulrik S Jensen, Caspar Corti, Jos A Van Oers, Ann R Falsey, Evelien de Jong, Carolina F Oliveira, Bianca Beghe, Matthias Briel, Beat Mueller
BACKGROUND: Acute respiratory infections (ARIs) comprise of a large and heterogeneous group of infections including bacterial, viral, and other aetiologies. In recent years, procalcitonin (PCT), a blood marker for bacterial infections, has emerged as a promising tool to improve decisions about antibiotic therapy (PCT-guided antibiotic therapy). Several randomised controlled trials (RCTs) have demonstrated the feasibility of using procalcitonin for starting and stopping antibiotics in different patient populations with ARIs and different settings ranging from primary care settings to emergency departments, hospital wards, and intensive care units...
October 13, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/29022532/hiv-positive-patients-in-the-intensive-care-unit-a-retrospective-audit
#11
P Mkoko, R I Raine
BACKGROUND: The indications for and outcomes of intensive care unit (ICU) admission of HIV-positive patients in resource-poor settings such as sub-Saharan Africa are unknown. OBJECTIVE: To identify indications for ICU admission and determine factors associated with high ICU and hospital mortality in HIV-positive patients. METHODS: We reviewed case records of HIV-positive patients admitted to the medical and surgical ICUs at Groote Schuur Hospital, Cape Town, South Africa, from 1 January 2012 to 31 December 2012...
September 22, 2017: South African Medical Journal, Suid-Afrikaanse Tydskrif Vir Geneeskunde
https://www.readbyqxmd.com/read/28991050/selective-lps-adsorption-using-polymyxin-b-immobilized-fiber-cartridges-in-sepsis-patients-following-cardiac-surgery
#12
Michael Yaroustovsky, Marina Abramyan, Ekaterina Komardina, Helen Nazarova, Dmitrii Popov, Marina Plyushch, Alina Soldatkina, Ekaterina Rogalskaya
Sepsis remains the leading cause of morbidity and mortality in intensive care units. The extracorporeal therapy in the complex treatment of sepsis seems to be the most promising direction.The aim of this study was to assess the safety and effectiveness of selective endotoxin adsorption on the basis of the analysis of our own experience with the intensive therapy for sepsis in adult cardiac surgical patients. MATERIALS AND METHODS: Our single-center study included 143 patients with sepsis...
October 4, 2017: Shock
https://www.readbyqxmd.com/read/28985715/acute-transient-spinal-paralysis-and-cardiac-symptoms-following-an-accidental-epidural-potassium-infusion-a-case-report
#13
Martin Kreutzträger, Marcel A Kopp, Thomas Liebscher
BACKGROUND: To describe a case of an accidental epidural potassium infusion leading to an acute transient spinal paralysis and cardiac symptoms and review the literature on that topic. CASE PRESENTATION: We report the case of an accidental infusion of 900 mg potassium chloride 7.45% (KCl) into the epidural space, which occurred during epidural analgesia in a 74-year-old patient suffering from immobilization due to lumbar back pain as well as from a paralytic Ileus...
October 6, 2017: BMC Anesthesiology
https://www.readbyqxmd.com/read/28984642/viral-infections-in-solid-organ-transplant-recipients-novel-updates-and-a-review-of-the-classics
#14
Ghady Haidar, Nina Singh
PURPOSE OF REVIEW: To summarize new discoveries in viral pathogenesis and novel therapeutic and prophylactic strategies in organ transplant recipients. RECENT FINDINGS: For decades, prophylaxis of cytomegalovirus (CMV) has been the standard preventive strategy, but new clinical trials are expected to determine the advantages of preemptive therapy over prophylaxis. Novel anti-CMV agents, such as maribavir and letermovir, are being studied for the treatment of resistant/refractory CMV as alternatives to foscarnet and cidofovir...
October 3, 2017: Current Opinion in Infectious Diseases
https://www.readbyqxmd.com/read/28984614/progression-of-duchenne-cardiomyopathy-presenting-with-chest-pain-and-troponin-elevation
#15
Kan N Hor, Pace Johnston, Kathi Kinnett, May Ling Mah, Corey Stiver, Larry Markham, Linda Cripe
BACKGROUND: Improved neuromuscular and respiratory therapies have altered the natural history of Duchenne muscular dystrophy (DMD) such that the most common cause of mortality is progressive cardiomyopathy. Despite imaging evidence of progressive cardiomyopathy, troponin I (cTn) is not significantly elevated in asymptomatic DMD patients. RESULTS: We describe eight boys with DMD evaluated for acute chest pain (ACP) and found to have acute cTn elevation with depressed left ventricular ejection fraction (LVEF)...
October 5, 2017: Journal of Neuromuscular Diseases
https://www.readbyqxmd.com/read/28978595/hiv-related-pneumocystis-jirovecii-pneumonia-managed-with-caspofungin-and-veno-venous-extracorporeal-membrane-oxygenation-rescue-therapy
#16
Nathaniel Lee, David Lawrence, Brijesh Patel, Stephane Ledot
Patients with pneumocystis pneumonia have a risk of progressing to acute respiratory failure necessitating admission to intensive care. The case described is of a patient with a newly diagnosed HIV infection presenting with pneumocystis pneumonia. Despite initiating the appropriate pharmacological treatment the patient's clinical condition deteriorated, and required both rescue pharmacological therapy with echinocandins as well as respiratory support with extracorporeal membrane oxygenation therapy. The patient recovered well on ventilator and circulatory support despite a long weaning process complicated by sequelae common to pneumocystis pneumonia...
October 4, 2017: BMJ Case Reports
https://www.readbyqxmd.com/read/28978214/strategies-to-manage-costs-in-idiopathic-pulmonary-fibrosis
#17
Gary M Owens
Idiopathic pulmonary fibrosis (IPF) is a diagnostically challenging disease. Clinicians are faced with the need to exclude alternative diagnoses, limited treatment and management guidelines, and few treatment options. Patients with IPF have significantly increased healthcare usage compared with similar patients without the disease. Medicare estimates for this disease are as high as $3 billion, not including cost of treatment. The disease, characterized by worsening dyspnea, declining lung function, nonspecific respiratory symptoms, and a varied clinical course randomly punctuated by episodes of acute exacerbations, is also accompanied by a host of comorbid conditions that contribute significantly to increased healthcare usage and cost...
July 2017: American Journal of Managed Care
https://www.readbyqxmd.com/read/28977203/noninvasive-ventilation-during-immediate-postoperative-period-in-cardiac-surgery-patients-systematic-review-and-meta-analysis
#18
Suzimara Monteiro Pieczkoski, Ane Glauce Freitas Margarites, Graciele Sbruzzi
OBJECTIVE: To verify the effectiveness of noninvasive ventilation compared to conventional physiotherapy or oxygen therapy in the mortality rate and prevention of pulmonary complications in patients during the immediate postoperative period of cardiac surgery. METHODS: Systematic review and meta-analysis recorded in the International Prospective Register of Ongoing Systematic Reviews (number CRD42016036441). The research included the following databases: MEDLINE, Cochrane Central, PEDro, LILACS and manual search of the references of studies published until March 2016...
July 2017: Brazilian Journal of Cardiovascular Surgery
https://www.readbyqxmd.com/read/28977101/extracorporeal-membrane-oxygenation-in-acute-respiratory-distress-syndrome-due-to-influenza-a-h1n1-pdm09-pneumonia-a-single-center-experience-during-the-2013-2014-season
#19
Nithya Menon, Carlos M Perez-Velez, Jennifer A Wheeler, Michael F Morris, Orazio L Amabile, Mark R Tasset, Robert A Raschke
OBJECTIVE: This report aimed to describe the outcomes of the patients with severe H1N1 associated acute respiratory distress syndrome who were treated with extracorporeal membrane oxygenation therapy. METHODS: This retrospective review analyzed a single-center cohort of adult patients with H1N1-related acute respiratory distress syndrome who were managed with veno-venous extracorporeal membrane oxygenation during the winter of 2013/2014. RESULTS: A total of 10 patients received veno-venous extracorporeal membrane oxygenation for H1N1 influenza between January 2013 and March 2014...
September 28, 2017: Revista Brasileira de Terapia Intensiva
https://www.readbyqxmd.com/read/28974837/laryngopharyngeal-reflux-disease-lprd
#20
Nizama Salihefendic, Muharem Zildzic, Emir Cabric
INTRODUCTION: Laryngopharyngeal reflux disease (LPRD) referes to an inflammatory reaction of the mucous membrane of pharynx, larynx and other associated respiratory organs, caused by a reflux of stomach contents into the esophagus. LPRD is considered to be a relatively new clinical entity with a vast number of clinical manifestations which are treated through different fields of medicine, often without a proper diagnosis. In gastroenterology it is still considered to be a manifestation of GERD, which stands for gastroesophageal reflux disease...
June 2017: Medical Archives
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