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https://www.readbyqxmd.com/read/28734773/epico-4-0-total-quality-in-the-management-of-invasive-candidiasis-in-critically-ill-patients-by-analysing-the-integrated-process
#1
Rafael Zaragoza, Ricard Ferrer, Pedro Llinares, Emilio Maseda, Alejandro Rodríguez, Santiago Grau, Guillermo Quindós
BACKGROUND: A high quality integrated process in the clinical setting of non-neutropenic critically ill patients at risk for invasive candidiasis is a necessary tool to improve the management of these patients. AIMS: To identify the key points on invasive candidiasis in order to develop a set of recommendations with a high level of consensus required for the creation of a total quality integrated process for the management of non-neutropenic critically ill patients at risk of invasive candidiasis...
July 19, 2017: Revista Iberoamericana de Micología
https://www.readbyqxmd.com/read/28732315/total-and-ionized-magnesium-testing-in-the-surgical-intensive-care-unit-opportunities-for-improved-laboratory-and-pharmacy-utilization
#2
Daniel Dante Yeh, Nalin Chokengarmwong, Yuchiao Chang, Liyang Yu, Colleen Arsenault, Joseph Rudolf, Elizabeth Lee-Lewandrowski, Kent Lewandrowski
PURPOSE: Ionized fraction (iMg) is the physiologically active form of magnesium (Mg); total Mg may not accurately reflect iMg status. Erroneously "low" Mg levels may result in unnecessary repetitive testing. MATERIALS AND METHODS: From 11/2015 to 01/2016, patients ordered for Mg from a pilot ICU also had iMg tested. Weighted kappa statistic was used to assess agreement between Mg categories (low, normal, high). Predictors of unnecessary repeated Mg testing and repletion using data were explored through logistic regression models using GEE techniques to account for repeated measurements in both bivariate and multivariable analyses...
July 11, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28731408/defining-the-biological-basis-of-radiomic-phenotypes-in-lung-cancer
#3
Patrick Grossmann, Olya Stringfield, Nehme El-Hachem, Marilyn M Bui, Emmanuel Rios Velazquez, Chintan Parmar, Ralph Th Leijenaar, Benjamin Haibe-Kains, Philippe Lambin, Robert Gillies, Hugo Jwl Aerts
Medical imaging can visualize characteristics of human cancer noninvasively. Radiomics is an emerging field that translates these medical images into quantitative data to enable phenotypic profiling of tumors. While radiomics has been associated with several clinical endpoints, the complex relationships of radiomics, clinical factors, and tumor biology are largely unknown. To this end, we analyzed two independent cohorts of respectively 262 North American and 89 European patients with lung cancer, and consistently identified previously undescribed associations between radiomic imaging features, molecular pathways, and clinical factors...
July 21, 2017: ELife
https://www.readbyqxmd.com/read/28730762/review-of-the-three-field-techniques-in-breast-cancer-radiotherapy
#4
John Kagkiouzis, Kalliopi Platoni, Ioanna Kantzou, Maria Dilvoi, George Patatoukas, Efrosyni Kypraiou, Efstathios Efstathopoulos, George Sarris, Nikolaos Trogkanis, Vassilis Kouloulias
Breast cancer is often treated with radiotherapy (RT), with two opposing tangential fields. When indicated, supraclavicular lymph nodes have to be irradiated, and a third anterior field is applied. The junction region has the potential to be over or underdosed. To overcome this problem, many techniques have been proposed. A literature review of 3 Dimensional Conformal RT (3D CRT) and older 3-field techniques was carried out. Intensity Modulated RT (IMRT) techniques are also briefly discussed. Techniques are categorized, few characteristic examples are presented and a comparison is attempted...
May 2017: Journal of B.U.ON.: Official Journal of the Balkan Union of Oncology
https://www.readbyqxmd.com/read/28726037/can-a-collaborative-subspecialty-antimicrobial-stewardship-intervention-have-lasting-effects
#5
Kaushal B Shah, Ramzy H Rimawi, Mark A Mazer, Paul P Cook
OBJECTIVE: We previously demonstrated the benefit of direct, daily collaboration between infectious disease (ID) and critical care practitioners (CCP) on guideline adherence and antibiotic use in the medical intensive care unit (MICU). In this post-intervention review, we sought to establish whether the effect on antibiotic use and guideline adherence was sustainable. DESIGN: A retrospective review of 87 patients, admitted to the 24-bed MICU, was done 3 (n = 45) and 6 months (n = 42) after the intervention...
July 19, 2017: Infection
https://www.readbyqxmd.com/read/28725900/luminescence-properties-and-warm-white-led-application-of-a-ternary-alkaline-fluoride-red-phosphor-k2naalf6-mn-4-%C3%A2
#6
L Y Wang, E H Song, T T Deng, Y Y Zhou, Z F Liao, W R Zhao, B Zhou, Q Y Zhang
Herein, a Mn(4+) ion doped complex ternary-alkaline fluoride red phosphor K2NaAlF6:Mn(4+) has been synthesized through a facile two-step co-precipitation method at room temperature. The crystal structure, morphological properties and influence of the dopant concentration, temperature and humidity on luminescence properties as well as the performance of the as-synthesized phosphor used in white light emitting diodes (WLEDs) were investigated carefully. Intense absorption in the blue region (∼460 nm) and bright narrow-band red emission (∼630 nm) with high color purity were observed from this resultant powder...
July 20, 2017: Dalton Transactions: An International Journal of Inorganic Chemistry
https://www.readbyqxmd.com/read/28724434/individual-contextual-factors-in-the-validation-of-the-bernese-pain-scale-for-neonates-protocol-for-a-prospective-observational-study
#7
Eva Cignacco, Karin Schenk, Bonnie Stevens, Liliane Stoffel, Dirk Bassler, Sven Schulzke, Mathias Nelle
BACKGROUND: The Bernese Pain Scale for Neonates (BPSN) is a multidimensional pain assessment tool that is already widely used in clinical settings in the German speaking areas of Europe. Recent findings indicate that pain responses in preterm neonates are influenced by individual contextual factors, such as gestational age (GA), gender and the number of painful procedures experienced. Currently, the BPSN does not consider individual contextual factors. Therefore, the aim of this study is the validation of the BPSN using a large sample of neonates with different GAs...
July 19, 2017: BMC Pediatrics
https://www.readbyqxmd.com/read/28723844/associations-of-physical-activity-intensities-with-markers-of-insulin-sensitivity
#8
Charlotte Jelleyman, Charlotte L Edwardson, Joseph Henson, Laura J Gray, Alex V Rowlands, Kamlesh Khunti, Melanie J Davies, Thomas Yates
BACKGROUND: Objectively measured physical activity (PA) intensity has traditionally been categorised as light, moderate and vigorous using laboratory calibrated cut-points. The relative contribution of time spent across a spectrum of accelerometer-determined intensities on health outcomes is less clear. PURPOSE: To assess the relationship between objectively measured PA intensity on a continuous scale and markers of insulin sensitivity. METHODS: Participants at high risk of type 2 diabetes were recruited from primary care (Leicestershire, UK)...
July 19, 2017: Medicine and Science in Sports and Exercise
https://www.readbyqxmd.com/read/28718341/diagnostic-yield-and-outcomes-of-computed-tomography-of-the-head-in-critically-ill-nontrauma-patients
#9
Fabian Finkelmeier, Sophie Walter, Kai-Henrik Peiffer, Anjali Cremer, Andrea Tal, Thomas Vogl, Stefan Zeuzem, Stephan Fichtlscherer, Mireen Friedrich-Rust, Jörg Bojunga, Harald Farnik
BACKGROUND: Computed tomography of the head (HCT) is a widely used diagnostic tool, especially for emergency and trauma patients. However, the diagnostic yield and outcomes of HCT for patients on medical intensive care units (MICUs) are largely unknown. METHODS: We retrospectively evaluated all head CTs from patients admitted to a single-center MICU during a 5-year period for CT indications, diagnostic yield, and therapeutic consequences. Uni- and multivariate analyses for the evaluation of risk factors for positive head CT were conducted...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28718340/characterization-of-sepsis-and-sepsis-associated-encephalopathy
#10
Qing Feng, Yu-Hang Ai, Hua Gong, Long Wu, Mei-Lin Ai, Song-Yun Deng, Li Huang, Qian-Yi Peng, Li-Na Zhang
BACKGROUND: Sepsis and sepsis-associated encephalopathy (SAE) are common intensive care unit (ICU) diseases; the morbidity and mortality are high. The present study analyzed the sensitivity of different diagnostic criteria of sepsis 1.0 and 3.0, epidemiological characteristics of sepsis and SAE, and explored its risk factors for death, short-term, and long-term prognosis. METHODS: The retrospective study included patients in ICU from January 2015 to June 2016. After excluding 58 patients, 175 were assigned to either an SAE or a non-SAE group (patients with sepsis but no encephalopathy)...
January 1, 2017: Journal of Intensive Care Medicine
https://www.readbyqxmd.com/read/28717513/unexpected-intensive-care-transfer-of-admitted-patients-with-severe-sepsis
#11
Gabriel Wardi, Arvin R Wali, Julian Villar, Vaishal Tolia, Christian Tomaszewski, Christian Sloane, Peter Fedullo, Jeremy R Beitler, Matthew Nolan, Daniel Lasoff, Rebecca E Sell
BACKGROUND: Patients with severe sepsis generally respond well to initial therapy administered in the emergency department (ED), but a subset later decompensate and require unexpected transfer to the intensive care unit (ICU). This study aimed to identify clinical factors that can predict patients at increased risk for delayed transfer to the ICU and the association of delayed ICU transfer with mortality. METHODS: This is a nested case-control study in a prospectively collected registry of patients with severe sepsis and septic shock at two EDs...
2017: Journal of Intensive Care
https://www.readbyqxmd.com/read/28715801/fetal-urine-production-rate-in-preterm-premature-rupture-of-membranes-is-associated-with-adverse-neonatal-outcome-a-pilot-study
#12
Tehila Avitan, Lior Drukker, Hadass Pri-Chen, Ron Rabinowitz, Nurit Algur, Michael S Schimmel, Letizia Schreiber, Tali Bdolah-Abram, Arnon Samueloff, Sorina Grisaru-Granovsky
AIM: In this study, we evaluate the associations between fetal urinary production rate (FUPR), measured by ultrasound, and adverse neonatal outcome in women with preterm premature rupture of membranes (PPROM). METHODS: We conducted a prospective pilot cohort of singleton pregnancies complicated by PPROM occurring at gestational week 24 or later managed until spontaneous labor (after 48 h of admission), chorioamnionitis, or induction by protocol at 35 + 0 weeks. FUPR was evaluated by 2D sonography at admission (corrected for gestational age)...
July 18, 2017: Gynecologic and Obstetric Investigation
https://www.readbyqxmd.com/read/28714738/dealing-with-daily-challenges-in-dementia-deal-id-study-process-evaluation-of-the-experience-sampling-method-intervention-partner-in-sight-for-spousal-caregivers-of-people-with-dementia
#13
Rosalia J M van Knippenberg, Marjolein E de Vugt, Claudia M J Smeets, Inez Myin-Germeys, Frans R J Verhey, Rudolf W Ponds
OBJECTIVES: This study describes the process evaluation of the experience sampling method (ESM) intervention 'Partner in Sight' for spousal caregivers of people with dementia. The aim was to determine internal and external validity of the intervention and provide information for future implementation in clinical practice. METHOD: Qualitative and quantitative data on sampling quality (recruitment and randomization, reach) and intervention quality (relevance and feasibility, adherence to protocol) were evaluated using descriptive statistics and conventional content analysis...
July 17, 2017: Aging & Mental Health
https://www.readbyqxmd.com/read/28712106/sensitivity-and-specificity-of-urinalysis-samples-in-critically-ill-patients
#14
Sean P Lee, Terrie Vasilopoulos, Thomas James Gallagher
BACKGROUND: Preemptive screening of urine for patients admitted to an intensive care unit can result in misinterpretation of data and over- or under-treatment of urinary tract infection. METHODS: Data were studied from 169 consecutive patients admitted to the neurologic or burn intensive care unit at Shands Hospital at the University of Florida. All patients had a urinary catheter in place at the time of admission. Urinalysis and urine culture were sent for analysis...
July 16, 2017: Anaesthesiology Intensive Therapy
https://www.readbyqxmd.com/read/28712016/a-survey-of-pesticide-accumulation-in-a-specialist-feeder-the-koala-phascolarctos-cinereus
#15
Caroline Marschner, Damien P Higgins, Mark B Krockenberger
To maintain profitability in Australia's agricultural and urban landscapes pesticides are used throughout the range of koala habitats. The koala is a specialist feeder, reliant on metabolic enzyme capacities to utilise a toxic diet of eucalypt leaves and is potentially prone to adverse effects when xenobiotic interactions between dietary and anthropogenic xenobiotics occur. The aim of this study was to investigate accumulation of frequently used pesticides in wild koalas in 4 areas of New South Wales and Queensland...
July 15, 2017: Bulletin of Environmental Contamination and Toxicology
https://www.readbyqxmd.com/read/28711778/the-efficacy-and-associated-bleeding-complications-of-recombinant-antithrombin-supplementation-among-intensive-care-unit-patients
#16
Hiroyuki Koami, Yuichiro Sakamoto, Ryota Sakurai, Miho Ohta, Hisashi Imahase, Mayuko Yahata, Mitsuru Umeka, Toru Miike, Futoshi Nagashima, Takashi Iwamura, Kosuke Chris Yamada, Satoshi Inoue
INTRODUCTION: The aim of this study was to evaluate the efficacy and complications of recombinant antithrombin (rAT) supplementation for adult patients with disseminated intravascular coagulation (DIC) compared with conventional plasma derived AT (pAT) treatment in the intensive care unit. MATERIALS AND METHODS: This study was performed in a single national university hospital in Japan. Adult patients from April 2015 to March 2016 with DIC were divided into two groups based on the type of AT agent used: the pAT group (n=24) and the rAT group (n=21)...
July 3, 2017: Thrombosis Research
https://www.readbyqxmd.com/read/28711678/linezolid-in-liver-failure-exploring-the-value-of-the-maximal-liver-function-capacity-limax-test-in-a-pharmacokinetic-pilot-study
#17
Sebastian G Wicha, Otto R Frey, Anka C Roehr, Johann Pratschke, Martin Stockmann, Rawan Alraish, Tilo Wuensch, Magnus Kaffarnik
BACKGROUND: Patients in the intensive care unit frequently require antibiotic treatment. Liver impairment possesses substantial challenges for dose selection in these patients. The aim of the present pilot study was to assess the novel maximal liver function capacity (LiMAx test) in comparison to conventional liver function markers as covariates of drug clearance in liver failure using linezolid as model drug. METHODS: 28 patients with different degrees of liver failure were recruited and LiMAx test, plasma, dialysis and urine sampling was performed under linezolid steady-state therapy (600 mg BID)...
July 12, 2017: International Journal of Antimicrobial Agents
https://www.readbyqxmd.com/read/28711381/effectiveness-assessment-of-a-guideline-based-protocol-for-ventilatory-support-management-of-copd-exacerbations-in-an-emergency-department
#18
Franciele Plachi, Fernando Nataniel Vieira, Danilo Cortozi Berton, Marli Knorst, Alexandre Simões Dias, Fernanda Machado Balzan
OBJECTIVES: To investigate clinical outcomes according to ventilatory support indication in subjects with chronic obstructive pulmonary disease exacerbation in a "real-life" Emergency Department and to analyze potential predictors of successful noninvasive positive pressure ventilation. METHODS: Retrospective cohort performed over an 18-month period, comparing the following patient groups with chronic obstructive pulmonary disease exacerbation: Group A composed of patients initially selected to receive noninvasive positive pressure ventilation without the subsequent need for invasive mechanical ventilation (successful-noninvasive positive pressure ventilation); Group B composed of patients transitioning from noninvasive positive pressure ventilation to invasive mechanical ventilation (failed-noninvasive positive pressure ventilation); and Group C composed of patients who presented with immediate need for invasive mechanical ventilation (without prior noninvasive positive pressure ventilation)...
July 5, 2017: Brazilian Journal of Physical Therapy
https://www.readbyqxmd.com/read/28711179/immediate-birth-an-analysis-of-women-and-their-babies-undergoing-time-critical-birth-in-a-tertiary-referral-obstetric-hospital
#19
M H Warren, J Kamania, A T Dennis
BACKGROUND: At our institution, the emergency obstetric 'code green' activates the system for immediate birth, usually by caesarean section. This study aimed to determine the incidence of immediate birth, indications, modes of anaesthesia, and short-term neonatal and maternal outcomes. METHOD: A review was performed for all women at the Royal Women's Hospital, Parkville, Australia who underwent immediate birth over a two-year period: January 1, 2013 to December 31, 2014...
June 16, 2017: International Journal of Obstetric Anesthesia
https://www.readbyqxmd.com/read/28711110/psychometric-properties-of-the-french-adaptation-of-the-basic-documentation-for-psycho-oncology-po-bado-a-distress-screening-tool
#20
Nena Stadelmaier, Kamel Gana, Yaël Saada, Odile Duguey-Cachey, Bruno Quintard
We translated and adapted the French version of the Basic Documentation for Psycho-Oncology (Po-Bado standard version) and we report its psychometric properties. The Po-Bado is a 12-item documentation instrument that measures psychosocial burden in cancer patients (all types and stages). The intensity of a patient's psychological suffering is evaluated by a health care professional (e.g., doctor, psychologist, nurse) in a semiguided interview. Overall, 252 cancer patients (Mage = 57 years, SD = 12.8 years) participated, completing the Po-Bado during a supportive care consultation following initial diagnosis...
September 2017: Behavior Therapy
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