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https://www.readbyqxmd.com/read/28521523/sepsis-in-internal-medicine-wards-current-knowledge-uncertainties-and-new-approaches-for-management-optimization
#1
Vincenzo Zaccone, Alberto Tosoni, Giovanna Passaro, Carla Vallone, Michele Impagnatiello, Domenica Donatella Li Puma, Salvatore De Cosmo, Raffaele Landolfi, Antonio Mirijello
Sepsis represents a global health problem in terms of morbidity, mortality, social and economic costs. Although usually managed in Intensive Care Units, sepsis showed an increased prevalence among Internal Medicine wards in the last decade. This is substantially due to the ageing of population and to multi-morbidity. These characteristics represent both a risk factor for sepsis and a relative contra-indication for the admission to Intensive Care Units. Although there is a lack of literature on the management of sepsis in Internal Medicine, the outcome of these patients seems to be gradually improving...
May 18, 2017: Annals of Medicine
https://www.readbyqxmd.com/read/28495951/biochemical-analysis-of-cerebrospinal-fluid-in-the-laboratories-of-deployed-medical-treatment-facilities-are-multistix-10-sg-strip-and-istat-useful
#2
Bertrand Lefrere, J Plantamura, C Renard, F Ceppa, H Delacour
INTRODUCTION: During military deployment, the diagnosis and the management of acute bacterial meningitis can be problematic, as deployed Medical Treatment Facilities (MTFs) often have a limited laboratory diagnostic capability. However, French Role 2 and 3 MTFs have point-of-care (POC) testing to perform urinary (Multistix 10 SG strip) and blood (iSTAT handheld analyser) biochemical testing mentioned in AMedP8.5. The purpose of this study was to compare the accuracy of this urine test strip and of the iSTAT CHEM8 and CG4 cartridges with a standard hospital bench top analyser in order to determine if these POC devices have a potential role in the biochemical analysis of cerebrospinal fluid (CSF protein, CSF glucose and CSF lactate, respectively)...
May 10, 2017: Journal of the Royal Army Medical Corps
https://www.readbyqxmd.com/read/28486375/domperidone-for-lactation-what-health-care-providers-need-to-know
#3
Catherine A Sewell, Christina Y Chang, Miriam M Chehab, Christine P Nguyen
This commentary serves to raise health care provider awareness about the regulatory status and available evidence regarding domperidone for insufficient lactation. Breastfeeding provides significant health benefits for mothers and infants, and insufficient milk production remains the most common reason for early weaning. Domperidone, a dopamine receptor antagonist that may increase milk production, is not approved for any human use in the United States. It is approved in some countries for certain gastrointestinal disorders, but is not approved in any country for lactation enhancement...
May 5, 2017: Obstetrics and Gynecology
https://www.readbyqxmd.com/read/28485837/characterization-of-the-analytic-performance-of-an-electrochemical-point-of-care-meter-for-measuring-%C3%AE-hydroxybutyrate-concentration-in-blood-and-plasma-from-periparturient-dairy-cattle
#4
Ameer A Megahed, Mark W H Hiew, Jonathan R Townsend, Peter D Constable
BACKGROUND: The Precision Xtra electrochemical meter is widely used to measure blood β-hydroxybutyrate concentration (BHBb) in dairy cattle. The meter uses an algorithm optimized for human blood that assumes the HCT in cattle is the same as in people, and that intra-erythrocyte β-hydroxybutyrate (BHBe) and plasma β-hydroxybutyrate (BHBp) concentration are equivalent. OBJECTIVES: The first objective was to characterize the analytic performance of the meter for measuring BHBb and BHBp in dairy cattle...
May 9, 2017: Veterinary Clinical Pathology
https://www.readbyqxmd.com/read/28441939/estimation-of-the-severity-of-breathlessness-in-the-emergency-department-a-dyspnea-score
#5
Tibor Gondos, Viktor Szabó, Ágnes Sárkány, Adrienn Sárkány, Gábor Halász
BACKGROUND: Dyspnea is a frequent complaint in emergency departments (ED). It has a significant amount of subjective and affective components, therefore the dyspnea scores, based on the patients' rating, can be ambiguous. Our purpose was to develop and validate a simple scoring system to evaluate the severity of dyspnea in emergency care, based on objectively measured parameters. METHODS: We performed a double center, prospective, observational study including 350 patients who were admitted in EDs with dyspnea...
April 26, 2017: BMC Emergency Medicine
https://www.readbyqxmd.com/read/28435897/association-between-lactate-clearance-during-post-resuscitation-care-and-neurologic-outcome-in-cardiac-arrest-survivors-treated-with-targeted-temperature-management
#6
Jung Chang Kim, Byung Kook Lee, Dong Hun Lee, Yong Hun Jung, Yong Soo Cho, Sung Min Lee, Seung Joon Lee, Chi Ho Park, Kyung Woon Jeung
OBJECTIVE: We investigated the association between lactate clearance or serum lactate levels and neurologic outcomes or in-hospital mortality in cardiac arrest survivors who were treated with targeted temperature management (TTM). METHODS: A retrospective analysis of data from cardiac arrest survivors treated with TTM between 2012 and 2015 was conducted. Serum lactate levels were measured on admission and at 12, 24, and 48 hours following admission. Lactate clearance at 12, 24, and 48 hours was also calculated...
March 2017: Clinical and Experimental Emergency Medicine
https://www.readbyqxmd.com/read/28404834/promotion-of-orange-fleshed-sweet-potato-increased-vitamin-a-intakes-and-reduced-the-odds-of-low-retinol-binding-protein-among-postpartum-kenyan-women
#7
Amy Webb Girard, Frederick Grant, Michelle Watkinson, Haile Selassie Okuku, Rose Wanjala, Donald Cole, Carol Levin, Jan Low
Background: Orange-fleshed sweet potato (OFSP) improves vitamin A (VA) status of young children; research with pregnant and lactating women is limited.Objective: We examined the effectiveness of the Mama SASHA (Sweetpotato Action for Security and Health in Africa) program to improve nutrition knowledge, diets, and nutritional status of pregnant and lactating women (PLW) in Western Kenya.Methods: Eight health facilities were allocated to the Mama SASHA intervention or comparison arms. PLW in intervention facilities received enhanced nutrition counseling at health clinics, were linked with community-based maternal support groups, and received vouchers for OFSP vine cuttings...
April 12, 2017: Journal of Nutrition
https://www.readbyqxmd.com/read/28350646/association-between-hospital-case-volume-of-sepsis-adherence-to-evidence-based-processes-of-care-and-patient-outcomes
#8
Ashraf Fawzy, Allan J Walkey
OBJECTIVES: We sought to explore potential mechanisms underlying hospital sepsis case volume-mortality associations by investigating implementation of evidence-based processes of care. DESIGN: Retrospective cohort study. We determined associations of sepsis case volume with three evidence-based processes of care (lactate measurement during first hospital day, norepinephrine as first vasopressor, and avoidance of starch-based colloids) and assessed their role in mediation of case volume-mortality associations...
June 2017: Critical Care Medicine
https://www.readbyqxmd.com/read/28346669/evaluation-of-a-point-of-care-electrochemical-meter-to-detect-subclinical-ketosis-and-hypoglycaemia-in-lactating-dairy-cows
#9
A Zakian, M Tehrani-Sharif, M R Mokhber-Dezfouli, M Nouri, P D Constable
OBJECTIVES: To evaluate and validate a hand-held electrochemical meter (Precision Xtra®) as a screening test for subclinical ketosis and hypoglycaemia in lactating dairy cattle. DESIGN: Method comparison study using a convenience sample. PROCEDURE: Blood samples were collected into plain tubes from the coccygeal vessels of 181 Holstein cows at 2-4 weeks of lactation during summer in Iran. Blood β-hydroxybutyrate concentration (BHB) and glucose concentration were immediately measured by the electrochemical meter after applying 20 μL of blood to the reagent strip...
April 2017: Australian Veterinary Journal
https://www.readbyqxmd.com/read/28298047/development-of-a-prediction-rule-for-diagnosing-postoperative-meningitis-a-cross-sectional-study
#10
Olga Helena Hernández Ortiz, Héctor Iván García García, Fabián Muñoz Ramírez, Juan Sebastián Cardona Flórez, Bladimir Alejandro Gil Valencia, Salvador Ernesto Medina Mantilla, María Juliana Moreno Ochoa, Jorge Eliécer Sará Ochoa, Fabián Jaimes
OBJECTIVE Diagnosing nosocomial meningitis (NM) in neurosurgical patients is difficult. The standard CSF test is not optimal and when it is obtained, CSF cultures are negative in as many as 70% of cases. The goal of this study was to develop a diagnostic prediction rule for postoperative meningitis using a combination of clinical, laboratory, and CSF variables, as well as risk factors (RFs) for CNS infection. METHODS A cross-sectional study was performed in 4 intensive care units in Medellín, Colombia. Patients with a history of neurosurgical procedures were selected at the onset of febrile symptoms and/or after an increase in acute-phase reactants...
March 10, 2017: Journal of Neurosurgery
https://www.readbyqxmd.com/read/28267667/smartphone-based-enzymatic-biosensor-for-oral-fluid-l-lactate-detection-in-one-minute-using-confined-multilayer-paper-reflectometry
#11
Donato Calabria, Cristiana Caliceti, Martina Zangheri, Mara Mirasoli, Patrizia Simoni, Aldo Roda
The development of smartphone-based biosensors for point-of-care testing (POCT) applications allows realizing "all in one" instruments, with large potential distribution among the general population. With this respect, paper color-based detection performed by reflectance measurement is the most popular, simple, inexpensive and straightforward method. Despite the large number of scientific publications related to these biosensors, they still suffer from a poor detectability and reproducibility related to inhomogeneity of color development, which leads to low assay reproducibility...
March 1, 2017: Biosensors & Bioelectronics
https://www.readbyqxmd.com/read/28238832/the-energetic-physiological-and-behavioral-response-of-lemon-sharks-negaprion-brevirostris-to-simulated-longline-capture
#12
Ian A Bouyoucos, Cory D Suski, John W Mandelman, Edward J Brooks
Commercial fisheries bycatch is a considerable threat to elasmobranch population recovery, and techniques to mitigate sub-lethal consequences can be improved with data on the energetic, physiological, and behavioral response of individuals to capture. This study sought to estimate the effects of simulated longline capture on the behavior, energy use, and physiological stress of juvenile lemon sharks (Negaprion brevirostris). Captive sharks equipped with acceleration biologgers were subjected to 1h of simulated longline capture...
February 24, 2017: Comparative Biochemistry and Physiology. Part A, Molecular & Integrative Physiology
https://www.readbyqxmd.com/read/28235428/validation-of-a-hand-held-point-of-care-device-for-lactate-in-adult-and-pediatric-patients-using-traditional-and-locally-smoothed-median-and-maximum-absolute-difference-curves
#13
Jessica Marie Colon-Franco, Stanley F Lo, Sergey S Tarima, David Gourlay, Amy L Drendel, E Brook Lerner
BACKGROUND: Lactate is commonly used in septic patients and is a viable biomarker for trauma patients. Its pre-hospital use could assist triaging and managing patients with these conditions. METHODS: We evaluated the analytical performance of the point-of-care (POC) StatStrip Xpress Lactate Meter (Nova Biomedical) and compared it to the ABL 800 (Radiometer). We measured lactate in 250 adult and 250 pediatric whole blood samples in 2 laboratories. The performance of the POC meter was assessed by traditional linear regression and Bland-Altman plots, and locally-smoothed (LS) median absolute difference and maximum absolute difference (MAD and MaxAD) curves...
February 21, 2017: Clinica Chimica Acta; International Journal of Clinical Chemistry
https://www.readbyqxmd.com/read/28220227/prediction-of-pediatric-sepsis-mortality-within-1%C3%A2-h-of-intensive-care-admission
#14
Luregn J Schlapbach, Graeme MacLaren, Marino Festa, Janet Alexander, Simon Erickson, John Beca, Anthony Slater, Andreas Schibler, David Pilcher, Johnny Millar, Lahn Straney
PURPOSE: The definitions of sepsis and septic shock have recently been revised in adults, but contemporary data are needed to inform similar approaches in children. METHODS: Multicenter cohort study including children <16 years admitted with sepsis or septic shock to ICUs in Australia and New Zealand in the period 2012-2015. We assessed septic shock criteria at ICU admission to define sepsis severity, using 30-day mortality as outcome. Through multivariable logistic regression, a pediatric sepsis score was derived using variables available within 60 min of ICU admission...
February 20, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28199348/presentation-management-and-outcomes-of-sepsis-in-adults-and-children-admitted-to-a-rural-ugandan-hospital-a-prospective-observational-cohort-study
#15
Kristina E Rudd, Leonard K Tutaryebwa, T Eoin West
OBJECTIVES: Limited data are available on sepsis in low-resource settings, particularly outside of urban referral centers. We conducted a prospective observational single-center cohort study in May 2013 to assess the presentation, management and outcomes of adult and pediatric patients admitted with sepsis to a community hospital in rural Uganda. METHODS: We consecutively screened all patients admitted to medical wards who met sepsis criteria. We evaluated eligible patients within 24 hours of presentation and 24-48 hours after admission, and followed them until hospital discharge...
2017: PloS One
https://www.readbyqxmd.com/read/28168816/lactate-levels-and-pneumonia-severity-index-are-good-predictors-of-in-hospital-mortality-in-pneumonia
#16
Bulut Demirel
INTRODUCTION: Pneumonia is an inflammatory disease caused by micro-organisms. The pneumonia severity index (PSI) and CURB_65 scores are widely used to predict the mortality risk. We wanted to calculate the value of lactic acid level in predicting the mortality risk. MATERIALS AND METHODS: This prospective cross-sectional study performed in a third level education and research hospital. The pneumonia diagnosis was determined by symptoms, physical examination findings, and radiological findings...
February 7, 2017: Clinical Respiratory Journal
https://www.readbyqxmd.com/read/28153301/electrochemiluminescence-bipolar-electrode-array-for-the-multiplexed-detection-of-glucose-lactate-and-choline-based-on-a-versatile-enzymatic-approach
#17
Yi Xiao, Linru Xu, Lian-Wen Qi
A simple, efficient and versatile biosensing platform capable of the multiplexed detection for glucose, lactate and choline was developed by the integration of bipolar electrochemistry and electrochemiluminescence (ECL) imaging. The sensing bipolar electrodes (BPEs) were simply modified via a one-step method adaptable to different enzymes. The biorecognition event happening between the substrate and the corresponding enzyme could be directly reported by the ECL emitted on the same pole from luminol and in situ generated H2O2...
April 1, 2017: Talanta
https://www.readbyqxmd.com/read/28151948/model-for-end-stage-liver-disease-excluding-inr-meld-xi-score-in-critically-ill-patients-easily-available-and-of-prognostic-relevance
#18
Bernhard Wernly, Michael Lichtenauer, Marcus Franz, Bjoern Kabisch, Johanna Muessig, Maryna Masyuk, Uta C Hoppe, Malte Kelm, Christian Jung
PURPOSE: MELD-XI, an adapted version of Model for End-stage Liver Disease (MELD) score excluding INR, was reported to predict outcomes e.g. in patients with acute heart failure. We aimed to evaluate MELD-XI in critically ill patients admitted to an intensive care unit (ICU) for prognostic relevance. METHODS: A total of 4381 medical patients (66±14 years, 2862 male) admitted to a German ICU between 2004 and 2009 were included and retrospectively investigated. Admission diagnoses were e...
2017: PloS One
https://www.readbyqxmd.com/read/28144779/focused-cardiac-ultrasound-in-the-early-resuscitation-of-severe-sepsis-and-septic-shock-a-prospective-pilot-study
#19
Hiroshi Sekiguchi, Yohei Harada, Hector R Villarraga, Sunil V Mankad, Ognjen Gajic
PURPOSE: Point-of-care ultrasonography has been increasingly used in the care of critically ill patients; however, reports on its use during active resuscitation are limited. The aim of this study was to investigate the true impact of focused cardiac ultrasound (FCU) during the management of sepsis with early (6-h) resuscitation. METHODS: A prospective pilot observational study was conducted at an academic medical center from March 2011 through July 2012. Patients undergoing resuscitation for severe sepsis or septic shock were prospectively enrolled at medical and combined medical-surgical intensive care units...
January 31, 2017: Journal of Anesthesia
https://www.readbyqxmd.com/read/28121217/qsofa-has-poor-sensitivity-for-prehospital-identification-of-severe-sepsis-and-septic-shock
#20
Maia Dorsett, Melissa Kroll, Clark S Smith, Phillip Asaro, Stephen Y Liang, Hawnwan P Moy
OBJECTIVES: Sepsis is a common and deadly disease process for which early recognition and intervention can significantly improve clinical outcomes. Despite this, sepsis remains underrecognized and therefore undertreated in the prehospital setting. Recent recommendations by the Society of Critical Care and European Society of Intensive Care Medicine advocate use of the qSOFA (quick Sequential [Sepsis-related] Organ Failure Assessment) score in non-ICU settings to screen for septic patients at greater risk for poor outcomes...
January 25, 2017: Prehospital Emergency Care
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