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https://www.readbyqxmd.com/read/28938290/body-composition-changes-in-severely-burned-children-during-icu-hospitalization
#1
Janos Cambiaso-Daniel, Ioannis Malagaris, Eric Rivas, Gabriel Hundeshagen, Charles D Voigt, Elizabeth Blears, Ron P Mlcak, David N Herndon, Celeste C Finnerty, Oscar E Suman
OBJECTIVES: Prolonged hospitalization due to burn injury results in physical inactivity and muscle weakness. However, how these changes are distributed among body parts is unknown. The aim of this study was to evaluate the degree of body composition changes in different anatomical regions during ICU hospitalization. DESIGN: Retrospective chart review. SETTING: Children's burn hospital. PATIENTS: Twenty-four severely burned children admitted to our institution between 2000 and 2015...
September 21, 2017: Pediatric Critical Care Medicine
https://www.readbyqxmd.com/read/28937460/utility-of-the-surgical-apgar-score-for-patients-who-undergo-surgery-for-spinal-metastasis
#2
Darryl Lau, Timothy J Yee, Frank La Marca, Rakesh Patel, Paul Park
STUDY DESIGN: Retrospective review of patients who underwent surgery for spinal metastasis between 2005 and 2011. OBJECTIVE: To assess the utility of the surgical Apgar score (SAS) in patients who underwent surgery for spinal metastasis. SUMMARY OF BACKGROUND DATA: Surgery for spinal metastasis can be associated with relatively high morbidity and mortality. Consequently, identifying patients at risk for major postoperative complications is important...
October 2017: Clinical Spine Surgery
https://www.readbyqxmd.com/read/28937333/provider-prioritized-domains-of-quality-in-pediatric-home-based-hospice-and-palliative-care-a-study-of-the-ohio-pediatric-palliative-care-and-end-of-life-network
#3
Rachel Thienprayoon, Melissa San Julian Mark, Daniel Grossoehme
BACKGROUND: Children receiving hospice and palliative care (HPC) differ from adults in important ways. Children are more likely to have rare diagnoses, less likely to have cancer, have longer lengths of stay on hospice, and are more likely to be technology dependent than adults. The National Consensus Project (NCP) in Palliative Care established domains of quality for HPC, but these domains have not been evaluated for applicability in children. OBJECTIVES: This study aims to establish consensus stakeholder-prioritized domains of high-quality pediatric home-based hospice and palliative care (HBHPC)...
September 22, 2017: Journal of Palliative Medicine
https://www.readbyqxmd.com/read/28936959/-correlation-between-apache-ii-scores-and-delirium-probability-of-senile-severe-pneumonia-patients-undergoing-invasive-mechanical-ventilation
#4
Xinghua Pei, Haiming Yu, Yanhong Wu, Xu Zhou
OBJECTIVE: To investigate the correlation between acute physiology and chronic health evaluation II (APACHE II) scores and delirium probability of senile severe pneumonia patients undergoing invasive mechanical ventilation (MV). METHODS: A retrospective study was conducted. Eighty-nine senile severe pneumonia patients undergoing invasive MV admitted to intensive care unit (ICU) of Hunan Provincial People's Hospital from January 2015 to March 2017 were enrolled. APACHE II scores were collected 24 hours before invasive MV...
September 2017: Zhonghua Wei Zhong Bing Ji Jiu Yi Xue
https://www.readbyqxmd.com/read/28936712/early-goal-directed-nutrition-versus-standard-of-care-in-adult-intensive-care-patients-the-single-centre-randomised-outcome-assessor-blinded-eat-icu-trial
#5
Matilde Jo Allingstrup, Jens Kondrup, Jørgen Wiis, Casper Claudius, Ulf Gøttrup Pedersen, Rikke Hein-Rasmussen, Mads Rye Bjerregaard, Morten Steensen, Tom Hartvig Jensen, Theis Lange, Martin Bruun Madsen, Morten Hylander Møller, Anders Perner
PURPOSE: We assessed the effects of early goal-directed nutrition (EGDN) vs. standard nutritional care in adult intensive care unit (ICU) patients. METHODS: We randomised acutely admitted, mechanically ventilated ICU patients expected to stay longer than 3 days in the ICU. In the EGDN group we estimated nutritional requirements by indirect calorimetry and 24-h urinary urea aiming at covering 100% of requirements from the first full trial day using enteral and parenteral nutrition...
September 22, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28936678/biomarker-based-strategy-for-early-discontinuation-of-empirical-antifungal-treatment-in-critically-ill-patients-a-randomized-controlled-trial
#6
Anahita Rouzé, Séverine Loridant, Julien Poissy, Benoit Dervaux, Boualem Sendid, Marjorie Cornu, Saad Nseir
PURPOSE: The aim of this study was to determine the impact of a biomarker-based strategy on early discontinuation of empirical antifungal treatment. METHODS: Prospective randomized controlled single-center unblinded study, performed in a mixed ICU. A total of 110 patients were randomly assigned to a strategy in which empirical antifungal treatment duration was determined by (1,3)-β-D-glucan, mannan, and anti-mannan serum assays, performed on day 0 and day 4; or to a routine care strategy, based on international guidelines, which recommend 14 days of treatment...
September 22, 2017: Intensive Care Medicine
https://www.readbyqxmd.com/read/28936580/use-of-cardiopulmonary-pump-support-during-coronary-artery-bypass-grafting-in-the-high-risk-a-meta-analysis
#7
A Yousif, D Addison, N Lakkis, T Rosengart, S S Virani, Y Birnbaum, M Alam
BACKGROUND: Data from randomized trials evaluating the efficacy of on- versus off-pump coronary artery bypass grafting remain inconclusive, particularly in high-risk populations. AIMS: The aim of this study is to compare the outcomes associated with on- versus off-pump coronary artery bypass grafting among high-risk patients. METHODS: We performed a meta-analysis of randomized control trials comparing on- versus off-pump coronary artery bypass grafting, focusing on high-risk populations...
September 21, 2017: Irish Journal of Medical Science
https://www.readbyqxmd.com/read/28936574/-imaging-techniques-in-modern-trauma-diagnostics
#8
T J Vogl, K Eichler, I Marzi, S Wutzler, K Zacharowski, C Frellessen
Modern trauma room management requires interdisciplinary teamwork and synchronous communication between a team of anaesthesists, surgeons and radiologists. As the length of stay in the trauma room influences morbidity and mortality of a severely injured person, optimizing time is one of the main targets. With the direct involvement of modern imaging techniques the injuries caused by trauma should be detected within a very short period of time in order to enable a priority-orientated treatment. Radiology influences structure and process quality, management and development of trauma room algorithms regarding the use of imaging techniques...
September 21, 2017: Medizinische Klinik, Intensivmedizin und Notfallmedizin
https://www.readbyqxmd.com/read/28936435/impact-of-enhanced-recovery-after-surgery-protocols-on-postoperative-morbidity-and-mortality-in-patients-undergoing-routine-hepatectomy-review-of-the-current-evidence
#9
Rahul Damania, Andrei Cocieru
BACKGROUND: Enhanced recovery protocols are widely used in many areas of general surgery but had a limited penetration in perioperative management of patients undergoing liver resection. Recently, multiple publications described application of enhanced recovery after surgery (ERAS) program to hepatectomy patients but their definitive role is not established or accepted by hepatobiliary surgeons. METHODS: A comprehensive literature review of published series in English language medical sources detailing ERAS program application for hepatectomy for the period of 2006-2016 is performed...
September 2017: Annals of Translational Medicine
https://www.readbyqxmd.com/read/28935681/sex-differences-in-the-utilization-and-outcomes-of-surgical-aortic-valve-replacement-for-severe-aortic-stenosis
#10
Zakeih Chaker, Vinay Badhwar, Fahad Alqahtani, Sami Aljohani, Chad J Zack, David R Holmes, Charanjit S Rihal, Mohamad Alkhouli
BACKGROUND: Studies assessing the differential impact of sex on outcomes of aortic valve replacement (AVR) yielded conflicting results. We sought to investigate sex-related differences in AVR utilization, patient risk profile, and in-hospital outcomes using the Nationwide Inpatient Sample. METHODS AND RESULTS: In total, 166 809 patients (63% male and 37% female) who underwent AVR between 2003 and 2014 were identified, and 48.5% had a concomitant cardiac surgery procedure...
September 21, 2017: Journal of the American Heart Association
https://www.readbyqxmd.com/read/28935665/evaluating-the-impact-of-implementing-a-clinical-practice-guideline-for-febrile-infants-with-positive-respiratory-syncytial-virus-or-enterovirus-testing
#11
Adrienne DePorre, David D Williams, Jennifer Schuster, Jason Newland, Jacqueline Bartlett, Rangaraj Selvarangan, Keith Mann, Russell McCulloh
OBJECTIVES: To evaluate clinical practice patterns and patient outcomes among febrile low-risk infants with respiratory syncytial virus (RSV) infection or enterovirus (EV) meningitis after implementing a clinical practice guideline (CPG) that provides recommendations for managing febrile infants with RSV infection and EV meningitis. METHODS: Our institution implemented a CPG for febrile infants, which gives explicit recommendations for managing both RSV-positive and EV-positive infants in 2011...
September 21, 2017: Hospital Pediatrics
https://www.readbyqxmd.com/read/28935345/robotic-thymectomy-is-feasible-for-large-thymomas-a-propensity-matched-comparison
#12
Peter J Kneuertz, Mohamed K Kamel, Brendon M Stiles, Benjamin E Lee, Mohamed Rahouma, Abu Nasar, Nasser K Altorki, Jeffrey L Port
BACKGROUND: Robotic-assisted thymectomy (RAT) is increasingly performed for resection of thymomas. Its application for large tumors remains controversial. In this study, we evaluated the safety and feasibility of RAT for large thymomas in comparison with transsternal thymectomy (ST). METHODS: A single institution database was reviewed for patients who underwent RAT for thymoma of 4 cm or larger between 2004 and 2016. Propensity scores were applied to match RAT with ST patients, based on age, sex, tumor size, and Masaoka stage...
September 18, 2017: Annals of Thoracic Surgery
https://www.readbyqxmd.com/read/28935115/characteristics-of-patients-with-constant-observers
#13
Susan Solimine, Junji Takeshita, Deborah Goebert, June Lee, Brian Schultz, Maria Guerrero, Michael Tanael, Mark Pilar, Loraine Fleming, Stacy Kracher, Leah Lawyer
BACKGROUND: The use of constant observers ("sitters") has been common practice in many medical centers to maintain patient safety. RESULTS: A retrospective chart review of patients who required sitters from October 1, 2007 to September 31, 2013 at a large, private hospital serving a multiethnic community showed that the top reasons for sitters include suicide risk, agitation, fall risk, interfering with medical devices, and confusion/disorientation. Sitters were used for a mean of 3...
August 10, 2017: Psychosomatics
https://www.readbyqxmd.com/read/28934706/untreated-hypertension-as-predictor-of-in-hospital-mortality-in-intracerebral-hemorrhage-a-multi-center-study
#14
Mario Hevesi, Eric M Bershad, Mostafa Jafari, Stephan A Mayer, Magdy Selim, Jose I Suarez, Afshin A Divani
PURPOSE: Hypertension is a significant risk factor for intracerebral hemorrhage (ICH). The importance of managing blood pressure to reduce the risk of ICH has been recognized. However, few studies have focused on ICH outcomes due to untreated hypertension. MATERIALS AND METHODS: We conducted a 5-year, retrospective, multicenter study of 490 consecutive ICH patients with histories of untreated-hypertension (n=56), treated-hypertension (n=314), and normotension (n=120)...
September 6, 2017: Journal of Critical Care
https://www.readbyqxmd.com/read/28934544/conjoint-tendon-release-in-direct-anterior-total-hip-arthroplasty-no-impact-on-patient-outcomes
#15
Reina Yao, James L Howard, Brent A Lanting
The direct anterior (DA) approach for total hip arthroplasty (THA) has become increasingly popular. However, femoral access can be more technically challenging in difficult cases as compared with other approaches. Conjoint tendon release can improve proximal femoral exposure, but its effect on patient function and pain has not been studied. This study evaluated the effect of conjoint tendon release on length of stay (LOS), inpatient pain medication requirements, and functional outcomes of patients undergoing DA THA...
September 21, 2017: Orthopedics
https://www.readbyqxmd.com/read/28934404/organizational-and-managerial-factors-associated-with-clinical-practice-guideline-adherence-a-simulation-based-study-in-36-french-hospital-wards
#16
Florence Saillour-Glénisson, Marion Kret, Sandrine Domecq, Matthieu Sibé, Valentin Daucourt, Virginie Migeot, David Veillard, Philippe Michel
Objectives: To identify managerial and organizational characteristics of multi-specialty medicine wards and individual characteristics of health professionals that are most strongly associated with clinical practice guidelines (CPG) adherence. Design: Cross-sectional stratified cluster sample design. Setting: Data were gathered from 36 randomly selected multi-specialty medicine wards. Participants: The study population included all health professionals involved in patient care working in the participating wards...
August 1, 2017: International Journal for Quality in Health Care
https://www.readbyqxmd.com/read/28934324/the-impact-of-community-based-palliative-care-on-acute-hospital-use-in-the-last-year-of-life-is-modified-by-time-to-death-age-and-underlying-cause-of-death-a-population-based-retrospective-cohort-study
#17
Katrina Spilsbury, Lorna Rosenwax, Glenn Arendts, James B Semmens
OBJECTIVE: Community-based palliative care is known to be associated with reduced acute care health service use. Our objective was to investigate how reduced acute care hospital use in the last year of life varied temporally and by patient factors. METHODS: A retrospective cohort study of the last year of life of 12,763 Western Australians who died from cancer or one of seven non-cancer conditions. Outcome measures were rates of hospital admissions and mean length of hospital stays...
2017: PloS One
https://www.readbyqxmd.com/read/28934019/cochlear-implantation-under-conscious-sedation-with-local-anesthesia-safety-efficacy-costs-and-satisfaction
#18
Samion Shabashev, Yasser Fouad, T Kate Huncke, J Thomas Roland
OBJECTIVE: To evaluate the safety, efficiency, cost effectiveness, and satisfaction of patients undergoing cochlear implantation under conscious sedation versus general anesthesia. STUDY DESIGN: Retrospective case review of 20 patients who underwent cochlear implantation under conscious sedation which was compared to 20 age-matched patients where surgery was performed under general anesthesia. METHODS: Perioperative times, length of stay, anesthesia drug costs, postoperative complications, and patient satisfaction were compared between the two groups...
September 21, 2017: Cochlear Implants International
https://www.readbyqxmd.com/read/28933952/impact-of-mandatory-microchipping-on-traceability-of-sheltered-dogs-in-the-czech-republic
#19
Jiri Zak, Eva Voslarova, Vladimir Vecerek, Iveta Bedanova
Records of 4,455 sheltered dogs were analyzed to compare the numbers of traceable (able to be reunited with original caregivers) and untraceable (unable to be reunited with original caregivers) dogs before (Period 1) and after (Period 2) introduction of a mandatory microchipping. Records were also used to compare the numbers of microchipped dogs, to compare dogs' reunification with caregivers, and to estimate possible financial savings. In Period 1, 51.8% of the dogs were untraceable (median length of stay = 14 days) and 48...
September 21, 2017: Journal of Applied Animal Welfare Science: JAAWS
https://www.readbyqxmd.com/read/28933252/laparoscopic-versus-open-resection-of-gastric-gastrointestinal-stromal-tumors-larger-than-5-cm-a-single-center-retrospective-study
#20
Guanglin Qiu, Jing Wang, Xiangming Che, Shicai He, Chao Wei, Xuqi Li, Ke Pang, Lin Fan
BACKGROUND: The technical feasibility and oncological safety of laparoscopic surgery for gastric gastrointestinal stromal tumors (GISTs) larger than 5 cm has not been adequately studied. Therefore, we performed this retrospective study to investigate the clinical outcomes of gastric GIST patients treated with laparoscopic surgery compared with those who underwent open surgery. METHODS: We retrospectively evaluated the outcomes of 48 consecutive patients who underwent gastric resection for gastric GISTs larger than 5 cm...
September 1, 2017: Surgical Innovation
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